title: Sonoelastography in the Evaluation of Plantar Fasciitis Treatment: 3-Month Follow-Up After Collagen Injection.
abstract: OBJECTIVE
  The aim of this study was to investigate whether ultrasound elastography can demonstrate the outcome of the treatment in comparison with gray-scale imaging.
  
  
  METHODS
  Sixteen patients (mean age, 46.9 years) with plantar fasciitis were prospectively enrolled after unsuccessful conservative treatment. Individuals graded their heel pain on a 100-mm visual analogue scale (VAS) and underwent gray-scale ultrasonography and sonoelastography. Collagen was injected in the heels. Fascial thickness and hypoechogenicity, perifascial edema, and plantar fascial elasticity were evaluated. Follow-up sonoelastography and VAS grading were done 3 months after the injection. Statistical analyses were performed by the paired t test and the Fisher exact test. A P < 0.05 was considered statistically significant.
  
  
  RESULTS
  Mean plantar fascial thickness showed insignificant decrease on follow-up (from 4.30 [1.37] to 4.23 [1.15] mm, P = 0.662). Fascial hypoechogenicity and perifascial edema did not change significantly after treatment. The mean strain ratio of the plantar fascia was significantly increased (from 0.71 [0.24] to 1.66 [0.72], P = 0.001). Softening of the plantar fascia decreased significantly after injection (from 12 to 3 ft, P = 0.004). Twelve (75%) of 16 patients showed significant VAS improvement at the follow-up.
  
  
  CONCLUSIONS
  Sonoelastography revealed a hardening of the plantar fascia after collagen injection treatment and could aid in monitoring the improvement of the symptoms of plantar fasciitis, in cases where gray-scale imaging is inconclusive.
authors.affiliation: Departments of *Radiology and †Orthopedic Surgery, Eulji Hospital, Eulji University, Seoul, South Korea.
authors.forename: Minchul
authors.initials: M
authors.lastname: Kim
authors.forename: Yun Sun
authors.initials: YS
authors.lastname: Choi
authors.forename: Myung-Won
authors.initials: MW
authors.lastname: You
authors.forename: Jin Su
authors.initials: JS
authors.lastname: Kim
authors.forename: Ki Won
authors.initials: KW
authors.lastname: Young
mesh_terms: D000328:Adult; D000368:Aged; D003094:Collagen / Q000627:therapeutic use*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D036981:Fasciitis, Plantar / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D003094:Collagen