title: Prognostic Value of Diagnostic Sonography in Patients With Plantar Fasciitis.
abstract: OBJECTIVE
  The primary objective of this study was to determine whether the sonographic appearance of the plantar fascia is predictive of the treatment (ie, pain) response in patients receiving supportive therapy for proximal plantar fasciitis. This study was a secondary analysis of data obtained from a randomized controlled trial of ambulatory adults, which examined the efficacy of 3 different foot supports for plantar fasciitis.
  
  
  METHODS
  Participants underwent diagnostic sonographic examinations of their heel at baseline and again at 3 months by a single experienced foot and ankle surgeon. Quantitative (eg, thickness) and qualitative (eg, biconvexity) characteristics of the fascia were recorded according to a standard protocol. Logistic regression models were used to identify predictors of the pain response.
  
  
  RESULTS
  Seventy patients completed a baseline evaluation, and 63 patients completed a 3-month follow-up assessment. The pain response was not associated with the type of foot support (P> .05). The only significant indicator of an unfavorable response in the univariate and multivariate analyses was biconvexity of the plantar fascia on sonography at presentation (multivariate odds ratio, 4.76 [95% confidence interval, 1.16-19.5; P= .030). Furthermore, changes in self-reported pain over the 3-month study period were not accompanied by alterations in plantar fascia thickness over this time (r = .056; P = .671).
  
  
  CONCLUSIONS
  We conclude that patients who present with biconvexity of the plantar fascia may be less responsive to tier 1 treatment regimens that center around mechanical support of the plantar fascia. Furthermore, follow-up measurements of the fascia in this population should not weigh heavily in decisions such as return to play.
authors: Weil Foot & Ankle Institute, Des Plaines, Illinois USA (A.E.F.); Center for Lower Extremity Ambulatory Research, Dr William M. Scholl College of Podiatric Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois USA (A.E.F., R.H.A., R.T.C.); Department of Diagnostic Radiology, Brigham and Women's Hospital, Boston, Massachusetts USA (T.K.); and Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan USA (J.S.W.). adam.fleischer@rosalindfranklin.edu.
authors: Adam E
authors: AE
authors: Fleischer
authors: Weil Foot & Ankle Institute, Des Plaines, Illinois USA (A.E.F.); Center for Lower Extremity Ambulatory Research, Dr William M. Scholl College of Podiatric Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois USA (A.E.F., R.H.A., R.T.C.); Department of Diagnostic Radiology, Brigham and Women's Hospital, Boston, Massachusetts USA (T.K.); and Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan USA (J.S.W.).
authors: Rachel H
authors: RH
authors: Albright
authors: Weil Foot & Ankle Institute, Des Plaines, Illinois USA (A.E.F.); Center for Lower Extremity Ambulatory Research, Dr William M. Scholl College of Podiatric Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois USA (A.E.F., R.H.A., R.T.C.); Department of Diagnostic Radiology, Brigham and Women's Hospital, Boston, Massachusetts USA (T.K.); and Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan USA (J.S.W.).
authors: Ryan T
authors: RT
authors: Crews
authors: Weil Foot & Ankle Institute, Des Plaines, Illinois USA (A.E.F.); Center for Lower Extremity Ambulatory Research, Dr William M. Scholl College of Podiatric Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois USA (A.E.F., R.H.A., R.T.C.); Department of Diagnostic Radiology, Brigham and Women's Hospital, Boston, Massachusetts USA (T.K.); and Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan USA (J.S.W.).
authors: Tatiana
authors: T
authors: Kelil
authors: Weil Foot & Ankle Institute, Des Plaines, Illinois USA (A.E.F.); Center for Lower Extremity Ambulatory Research, Dr William M. Scholl College of Podiatric Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois USA (A.E.F., R.H.A., R.T.C.); Department of Diagnostic Radiology, Brigham and Women's Hospital, Boston, Massachusetts USA (T.K.); and Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan USA (J.S.W.).
authors: James S
authors: JS
authors: Wrobel
mesh_terms: D000328:Adult; D000368:Aged; D005205:Fascia / Q000000981:diagnostic imaging; D036981:Fasciitis, Plantar / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010146:Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014463:Ultrasonography / Q000379:methods*
keywords: biconvexity; heel pain; musculoskeletal ultrasound; plantar fascia; predictors; sonography