Ultrasound and MRI Findings in Patients with Planter Fasciitis

  • Dr. Mohammed AbdKadhim M.B.Ch.B., F.I.B.M.S , Professor in diagnostic radiology, Iraqi board of medical specialization and Medical collage/ Al-Nahrain university.‎ Consultant radiologist in Al-Imamian Al-Kadhimyian medical city/ Baghdad/ Iraq
  • Dr. Noor Jalal Al-deen M.B.Ch.B , Radiologist in Al-Imamian Al-Kadhimyian medical city/ Baghdad Iraq
Keywords: plantar fasciitis, ultrasound, MRI.

Abstract

Background: planter fasciitis is the most common painful heel condition caused by inflammation at the insertion of the planter fascia on the medial process of the calcaneal tuberosity…it is usually clinically diagnosed but radiological imaging used for confirmation of the diagnosis and exclusion of the other conditions (such as foreign bodies, PF rupture, calcaneal bursitis….etc.) that may have same clinical presentation. Aim of the study: to assess the ultrasonography and MRI findings in patients with planter fasciitis. Patients  and Method: In across sectional study of 34 patients(16 men and 18 women) with suspected unilateral or bilateral plantar fasciitis, 46 symptomatic heels were examined by both high-resolution ultrasound and magnetic resonance imaging (MRI) protocol to assess the different signs;11 healthy volunteers (22 heels) acted as controls. Results: in symptomatic feet, the plantar fascia was thickened. The thickness of the plantar fascia in symptomatic feet was (3.5–7.5 mm in range; mean 5.5mm ± 1.3) measured by ultrasound which was significantly thicker than in the control group (2–2.8 mm in range; mean 2.4mm± 0.07); P < 0.05. Other sonographic signs used for the diagnosis of plantar fasciitis in the study were compared to MRI findings. The diagnostic accuracy was 78.2% for abnormal intrinsic echogenicity within the plantar fascia, 73.9% for focal thickening ,60.8% for subcutaneous edema around the plantar fascia, and the lowest diagnostic accuracy of ultrasound was in detection of associated calcaneal spur (56.5%). The findings were compared and discussed in relation to other thesis. Conclusion: Ultrasonographic diagnosis of planter fasciitis is a useful tool compared to MRI and it could be the easy initial imaging modality for confirmation of clinically suspected plantar fasciitis. MRI may be kept for cases where a diagnosis of plantar fasciitis does not confidently explain the clinical presentation and when complex pathology is suspected.

Author Biography

Dr. Noor Jalal Al-deen, M.B.Ch.B , Radiologist in Al-Imamian Al-Kadhimyian medical city/ Baghdad Iraq
 

References

. Miller, M. and Thompson, S. (2016). Miller's review of orthopaedics. 7th ed. Philadelphia: Elsevier, p.535.

. E. de Miguel et al., "Validity of enthesis ultrasound assessment in spondyloarthropathy", Annals of the Rheumatic Diseases, vol. 68, no. 2, pp. 169-174, 2009. Available: 10.1136/ard.2007.084251.

. "Ultrasonographic evaluation of low energy extracorporeal pulse activated therapy (EPAT) for chronic plantar fasciitis", Fuß & Sprunggelenk, vol. 10, no. 3, p. 198, 2012. Available: 10.1016/j.fuspru.2012.05.003.

. A. McMillan, K. Landorf, M. Gilheany, A. Bird, A. Morrow and H. Menz, "Ultrasound guided corticosteroid injection for plantar fasciitis: randomised controlled trial", BMJ, vol. 344, no. 221, pp. e3260-e3260, 2012. Available: 10.1136/bmj.e3260.

. L. Solomon, D. Warwick, S. Nayagam and A. Apley, Apley's system of orthopaedics and fractures.9th ed. London: Hodder Arnold, 2010, p. 618.

. W. Gibbon and G. Long, "Ultrasound of the plantar aponeurosis (fascia)", Skeletal Radiology, vol. 28, no. 1, pp. 21-26, 1999. Available: 10.1007/s002560050467.

. F. Draghi, S. Gitto, C. Bortolotto, A. Draghi and G. Ori Belometti, "Imaging of plantar fascia disorders: findings on plain radiography, ultrasound and magnetic resonance imaging", Insights into Imaging, vol. 8, no. 1, pp. 69-78, 2016. Available: 10.1007/s13244-016-0533-2.

. K. Tsikopoulos, H. Vasiliadis and D. Mavridis, "Injection therapies for plantar fasciopathy (‘plantar fasciitis’): a systematic review and network meta-analysis of 22 randomised controlled trials", British Journal of Sports Medicine, vol. 50, no. 22, pp. 1367-1375, 2016. Available: 10.1136/bjsports-2015-095437.

. S. Gitto and F. Draghi, "Normal Sonographic Anatomy of the Wrist With Emphasis on Assessment of Tendons, Nerves, and Ligaments", Journal of Ultrasound in Medicine, vol. 35, no. 5, pp. 1081-1094, 2016. Available: 10.7863/ultra.15.06105.

. K. Abul, D. Ozer, S. Sakizlioglu, A. Buyuk and M. Kaygusuz, "Detection of Normal Plantar Fascia Thickness in Adults via the Ultrasonographic Method", Journal of the American Podiatric Medical Association, vol. 105, no. 1, pp. 8-13, 2015. Available: 10.7547/8750-7315-105.1.8.

. N. ABDEL-WAHAB, S. FATHI, S. AL-EMADI and S. MAHDI, "High-resolution ultrasonographic diagnosis of plantar fasciitis: a correlation of ultrasound and magnetic resonance imaging", International Journal of Rheumatic Diseases, vol. 11, no. 3, pp. 279-286, 2008. Available: 10.1111/j.1756-185x.2008.00363.x.

. H. Ozdemir, E. Yilmaz, A. Murat, L. Karakurt, A. Poyraz and E. Ogur, "Sonographic evaluation of plantar fasciitis and relation to body mass index", European Journal of Radiology, vol. 54, no. 3, pp. 443-447, 2005. Available: 10.1016/j.ejrad.2004.09.004.

. E. Cardinal, R. Chhem, C. Beauregard, B. Aubin and M. Pelletier, "Plantar fasciitis: sonographic evaluation.", Radiology, vol. 201, no. 1, pp. 257-259, 1996. Available: 10.1148/radiology.201.1.8816554.

. Ismail Khalifa, R.TantawyAmeen and A.Abdelhameed, " High resolution ultrasonography versus plain x-ray in diagnosis of plantar fasciitis ", AAMJ, Vol. 8, N. 2 ,2010.

. N. Sabir, S. Demirlenk, B. Yagci, N. Karabulut and S. Cubukcu, "Clinical Utility of Sonography in Diagnosing Plantar Fasciitis", Journal of Ultrasound in Medicine, vol. 24, no. 8, pp. 1041-1048, 2005. Available: 10.7863/jum.2005.24.8.1041.

. M. Akfirat, C. Sen and T. Günes, "Ultrasonographic appearance of the plantar fasciitis", Clinical Imaging, vol. 27, no. 5, pp. 353-357, 2003. Available: 10.1016/s0899-7071(02)00591-0.

. Wen-Chung Tsai, Ming-Fa Chiu, Chung, "Ultrasound evaluation of plantar fasciitis", Scandinavian Journal of Rheumatology, vol. 29, no. 4, pp. 255-259, 2000. Available: 10.1080/030097400750041415.

. H. Genc, M. Saracoglu, B. Nacır, H. Erdem and M. Kacar, "Long-term ultrasonographic follow-up of plantar fasciitis patients treated with steroid injection", Joint Bone Spine, vol. 72, no. 1, pp. 61-65, 2005. Available: 10.1016/j.jbspin.2004.03.006.

. D. Blankenbaker and A. De Smet, "The Role of Ultrasound in the Evaluation of Sports Injuries of the Lower Extremities", Clinics in Sports Medicine, vol. 25, no. 4, pp. 867-897, 2006. Available: 10.1016/j.csm.2006.06.004.

. K. Finlay and L. Friedman, "Ultrasonography of the Lower Extremity", Orthopedic Clinics of North America, vol. 37, no. 3, pp. 245-275, 2006. Available: 10.1016/j.ocl.2006.03.002.

Published
2019-07-10
Section
Articles