Comparison of ultrasound-, palpation-, and scintigraphy-guided steroid injections in the treatment of plantar fasciitis

Background The aim of the study was to compare the efficacies of steroid injections guided by scintigraphy, ultrasonography, and palpation in plantar fasciitis. Methods A total of 35 heels of 27 patients were randomly assigned to three steroid injection groups: palpation-guided (pg), ultrasound-guid...

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Bibliographic Details
Published in:Archives of orthopaedic and trauma surgery 2009-05, Vol.129 (5), p.695-701
Main Authors: Yucel, Istemi, Yazici, Burhan, Degirmenci, Erdem, Erdogmus, Besir, Dogan, Semih
Format: Article
Language:English
Subjects:
Adult
Anti-Inflammatory Agents - administration & dosage
Betamethasone - administration & dosage
Betamethasone - analogs & derivatives
Body Mass Index
Fascia - diagnostic imaging
Fascia - drug effects
Fascia - pathology
Fasciitis, Plantar - diagnostic imaging
Fasciitis, Plantar - drug therapy
Fasciitis, Plantar - pathology
Female
Foot - diagnostic imaging
Humans
Injections, Intralesional - methods
Male
Medicine
Medicine & Public Health
Middle Aged
Orthopaedic Outcome Assessment
Orthopedics
Pain Measurement
Palpation
Radionuclide Imaging
Ultrasonic imaging
Ultrasonography
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Summary:Background The aim of the study was to compare the efficacies of steroid injections guided by scintigraphy, ultrasonography, and palpation in plantar fasciitis. Methods A total of 35 heels of 27 patients were randomly assigned to three steroid injection groups: palpation-guided (pg), ultrasound-guided (ug), and scintigraphy-guided (sg). Patients were evaluated for pain intensity before the injections and at the last follow-up of 25.3 months with a 100-mm visual analog scale (VAS). Results There were significant improvements in plantar fascia thickness, fat pad thickness, and VAS. Among the three groups of ug–pg, ug–sg, and pg–sg there were no statistically significant differences after treatment ( P  = 0.017, MWU = 36.5; P  = 0.023, MWU = 29.5; and P  = 0.006, MWU = 13, respectively). Conclusions The ug, pg, and sg injections were effective in the conservative treatment of plantar fasciitis. We are of the opinion that steroid injections should be performed, preferably with palpation or ultrasonographic guidance.
ISSN:0936-8051
1434-3916
DOI:10.1007/s00402-008-0760-1