title: Ultrasound- versus palpation-guided injection of corticosteroid for plantar fasciitis: a meta-analysis.
abstract: BACKGROUND
  It is controversial whether ultrasound-guided injection of corticosteroid is superior to palpation-guided injection for plantar fasciitis. This meta-analysis was performed to compare the effectiveness of ultrasound-guided and palpation-guided injection of corticosteroid for the treatment of plantar fasciitis.
  
  
  METHODS
  Databases (MEDLINE, Cochrane library and EMBASE) and reference lists were searched from their establishment to August 30, 2013 for randomized controlled trials (RCTs) comparing ultrasound-guided with palpation-guided injection for plantar fasciitis. The Cochrane risk of bias (ROB) tool was used to assess the methodological quality. Outcome measurements were visual analogue scale (VAS), tenderness threshold (TT), heel tenderness index (HTI), response rate, plantar fascia thickness (PFT), hypoechogenicity and heel pad thickness (HPT). The statistical analysis was performed with software RevMan 5.2 and Stata 12.0. When I2<50%, the fixed-effects model was adopted. Otherwise the randomized-effects model was adopted. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was used to assess the quality of evidence.
  
  
  RESULTS
  Five RCTs with 149 patients were identified and analyzed. Compared with palpation-guided injection, ultrasound-guided injection was superior with regard to VAS, TT, response rate, PFT and hypoechogenicity. However, there was no statistical significance between the two groups for HPT and HTI.
  
  
  CONCLUSIONS
  Ultrasound-guided injection of corticosteroid tends to be more effective than palpation-guided injection. However, it needs to be confirmed by further research.
authors.affiliation: Department of Orthopedics, Zhongnan Hospital of Wuhan University, Wuhan, China.
authors.forename: Zonghuan
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Orthopedics, Zhongnan Hospital of Wuhan University, Wuhan, China.
authors.forename: Chengyan
authors.initials: C
authors.lastname: Xia
authors.affiliation: Department of Orthopedics, Zhongnan Hospital of Wuhan University, Wuhan, China.
authors.forename: Aixi
authors.initials: A
authors.lastname: Yu
authors.affiliation: Department of Orthopedics, Zhongnan Hospital of Wuhan University, Wuhan, China.
authors.forename: Baiwen
authors.initials: B
authors.lastname: Qi
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D036981:Fasciitis, Plantar / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D015552:Injections, Intralesional; D016017:Odds Ratio; D017594:Publication Bias; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents