Role of high-resolution ultrasound in guiding treatment of idiopathic plantar fasciitis with minimally invasive techniques

• Published in: Radiologia medica 2008-06, Vol.113 (4), p.486-495
• Main Authors: Sorrentino, F., Iovane, A., Vetro, A., Vaccari, A., Mantia, R., Midiri, M.
• Format: Article
• Language: English
• Subjects: Diagnostic Radiology; Fasciitis, Plantar - diagnostic imaging; Fasciitis, Plantar - drug therapy; Fasciitis, Plantar - therapy; Female; Glucocorticoids - administration & dosage; High-Energy Shock Waves - therapeutic use; Humans; Imaging; Injections, Intralesional; Interventional Radiology; Male; Medicine; Medicine & Public Health; Middle Aged; Musculoskeletal Radiology/Radiologia Muscolo-Scheletrica; Neuroradiology; Pain Measurement; Patient Satisfaction; Radiology; Sicily; Treatment Outcome; Ultrasonic Therapy - methods; Ultrasonography, Interventional; Ultrasound
• ISSN: 0033-8362; 1826-6983
• DOI: 10.1007/s11547-008-0277-2

Purpose The aim of this study was to assess the reliability of perifascial oedema as a sonographic criterion for selecting the most appropriate treatment (ultrasoundguided corticosteroid injection or ultrasound-guided extracorporeal shock wave therapy) of idiopathic plantar fasciitis (IPF). Materials and methods Sixty-four patients with a clinical diagnosis of unilateral refractory IPF, treated conservatively for at least 8 weeks, were studied with highresolution ultrasound (HRUS). Pain intensity was evaluated with a visual analogue scale (VAS). HRUS was used to confirm IPF and identify the presence of perifascial oedema. Patients with an HRUS diagnosis of IPF were grouped according to the presence (A) or absence (B) of perifascial oedema and then randomly allocated to treatment with corticosteroid injection (1) or extracorporeal shock wave therapy (2). Clinical and HRUS follow-up was performed 6 weeks after treatment. Results HRUS confirmed IPF in 68,97% of patients and identified perifascial oedema in 53.33%. Clinical and sonographic improvements were observed in 87.5% and 37.5% of patients in subgroups A1 and A2, respectively, and in 35.71% and 92.85% of those in subgroups B1 and B2, respectively. Conclusions The presence of perifascial oedema may represent an effective criterion for guiding treatment decisions towards HRUS-guided corticosteroid injection.