Correlation between the outcome of extracorporeal shockwave therapy and pretreatment MRI findings for chronic plantar fasciitis.
BACKGROUND
The purpose of this study was to investigate the relationship between magnetic resonance imaging (MRI) findings before extracorporeal shockwave therapy (ESWT) and the treatment outcome of ESWT.


METHODS
This study examined 50 feet with chronic plantar fasciitis. The scores before ESWT and after a six-month follow-up were investigated using the Japanese Society for Surgery of the Foot (JSSF) Ankle-Hindfoot Scale and the Visual Analog Scale (VAS). MRI before ESWT was used for image evaluation. MRI revealed thickening of the plantar fascia (PF), and an investigation was conducted regarding the findings of a high-signal-intensity area (HSIA) inside the PF, edema near the PF, and bone marrow edema (BME) of the calcaneus.


RESULTS
The average JSSF score and VAS score improved significantly at follow-up. In total, 44 feet were noted in the improved group. MRI revealed that the average amounts of PF thickening did not significantly differ between the improved group and the non-improved group. HSIA, edema near the PF, and BME were observed in 36, 41, and 11 feet in the improved group, respectively; and 2, 4, and 2 feet in the non-improved group, respectively.


CONCLUSIONS
An HSIA in the PF predicted symptom improvement more easily than other MRI findings.


METHODS
IV.
Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine , Kamigyo-ku, Kyoto , Japan.
Masahiro
M
Maki
Kazuya
K
Ikoma
Kan
K
Imai
Masamitsu
M
Kido
Yusuke
Y
Hara
Yuji
Y
Arai
Hiroyoshi
H
Fujiwara
Toshikazu
T
Kubo
D000293:Adolescent; D000328:Adult; D000368:Aged; D036981:Fasciitis, Plantar / Q000473:pathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D005528:Foot / Q000473:pathology*; D019220:High-Energy Shock Waves / Q000627:therapeutic use*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D055815:Young Adult
Chronic plantar fasciitis; Extracorporeal shockwave therapy; Magnetic resonance imaging; Multiple logistic regression analysis; Visual Analog Scale