ArticlesTreatment of proximal plantar fasciitis with ultrasound-guided steroid injection☆,☆☆,★
Section snippets
Subjects
Fourteen consecutive patients with unilateral plantar fasciitis, between the ages of 35 and 80, enrolled in the present study. Their physical characteristics are shown in table 1. Values are reported as mean ± SD.Characteristic Value Gender (male:female) 1:13 Lesion (right:left) 6:8 Age (yr) 48.4 ± 10.8 Height (cm) 159.0 ± 7.1 Weight (kg) 67.6 ± 10.2 Body mass index (kg/m2) 26.87 ± 4.63
Ultrasonographic findings
On sonograms, the heel has a sharp high-intensity interface at the skin surface, then a finite area of soft tissue of medium acoustic intensity, and then another sharp bright interface representing the calcaneal soft tissue junction (fig 3). The calcaneus was identified by observation of acoustic shadowing. The plantar fascia was recognized by its moderately echogenic, striated appearance with insertion on the calcaneus. The edges were well defined by 2 echogenic lines (fig 1A). The plantar
Discussion
The plantar fascia arising from the calcaneal tuberosity to the forefoot and spanning the longitudinal arch has been shown to be the most important structure for dynamic arch support.26, 27 Overuse and microtears from repetitive trauma are thought to contribute to plantar fasciitis. When the plantar fascia assumes a greater share of force than it can accommodate physiologically, plantar fasciitis may result. This overload may cause microtears in the fascia at or near the fascia-bone interface.28
Conclusion
Ultrasound is useful in enhancing the accuracy of steroid injection because it precisely localizes the lesion and needle placement. Instead of relying on subjective VAS and TT, it offers objective measurements of the therapeutic effect, including the decreased thickness and disappearance of hypoechogenicity in the plantar fascia. No deterioration of mechanical properties of the heel pads (including pad atrophy) occurred, which means that the fat pad was not adversely affected by a single
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Comparison of midterm results of Platelet Rich Plasma (PRP) versus Steroid for plantar fasciitis: A randomized control trial of 118 patients
2021, Journal of Clinical Orthopaedics and TraumaCitation Excerpt :In present study PRP was administered at the point of maximum tenderness of the heel. Previous studies have advocated the use of ultrasound guidance for the injection in plantar fasciitis,35,36 since this could allow for more accurate placement of the injection. However, results from the trials conducted by Tsai and Kane suggested that ultrasound-guided injection did not appear to more effective than palpation-guided injection in the treatment of idiopathic plantar fasciitis.37,38
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No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.
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Reprint requests to Fuk-Tan Tang, Department of Physical Medicine & Rehabilitation, Chang Gung Memorial Hospital 5, Fu-Shin St, Gueishan, Taoyuan Hsien, Taiwan; e-mail: [email protected].
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