title: Plantar fascia softening in plantar fasciitis with normal B-mode sonography.
abstract: OBJECTIVE
  To investigate plantar fascia elasticity in patients with typical clinical manifestations of plantar fasciitis but normal plantar fascia morphology on B-mode sonography.
  
  
  METHODS
  Twenty patients with plantar fasciitis (10 unilateral and 10 bilateral) and 30 healthy volunteers, all with normal plantar fascia morphology on B-mode sonography, were included in the study. Plantar fascia elasticity was evaluated by sonoelastographic examination. All sonoelastograms were quantitatively analyzed, and less red pixel intensity was representative of softer tissue. Pixel intensity was compared among unilateral plantar fasciitis patients, bilateral plantar fasciitis patients, and healthy volunteers by one-way ANOVA. A post hoc Scheffé's test was used to identify where the differences occurred.
  
  
  RESULTS
  Compared to healthy participants (red pixel intensity: 146.9 ± 9.1), there was significantly less red pixel intensity in the asymptomatic sides of unilateral plantar fasciitis (140.4 ± 7.3, p = 0.01), symptomatic sides of unilateral plantar fasciitis (127.1 ± 7.4, p < 0.001), and both sides of bilateral plantar fasciitis (129.4 ± 7.5, p < 0.001). There were no significant differences in plantar fascia thickness or green or blue pixel intensity among these groups.
  
  
  CONCLUSIONS
  Sonoelastography revealed that the plantar fascia is softer in patients with typical clinical manifestations of plantar fasciitis, even if they exhibit no abnormalities on B-mode sonography.
authors.affiliation: Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, College of Medicine, National Taiwan University, No.7 Chung-Shan South Road, 100, Taipei, Taiwan.|Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan.
authors.forename: Chueh-Hung
authors.initials: CH
authors.lastname: Wu
authors.affiliation: Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, College of Medicine, National Taiwan University, No.7 Chung-Shan South Road, 100, Taipei, Taiwan.
authors.forename: Wen-Shiang
authors.initials: WS
authors.lastname: Chen
authors.affiliation: Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, College of Medicine, National Taiwan University, No.7 Chung-Shan South Road, 100, Taipei, Taiwan. tgw@ntu.edu.tw.
authors.forename: Tyng-Guey
authors.identifier: http://orcid.org/0000-0003-3298-4916
authors.initials: TG
authors.lastname: Wang
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D005205:Fascia / Q000000981:diagnostic imaging; D036981:Fasciitis, Plantar / Q000000981:diagnostic imaging*; D005260:Female; D005528:Foot / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D014463:Ultrasonography
keywords: Elastography; Musculoskeletal; Ultrasound