Abstract
Objectives
To assess the advantage of the addition of shear wave elastography (SWE) to gray-scale sonography in the diagnosis of plantar fasciitis.
Methods
30 subjects between 18–60 years of age with unilateral heel pain who were clinically suspected of having plantar fasciitis were included in this study. Their affected feet were taken as cases; while their contralateral feet served as controls. On gray-scale ultrasound, the thickness of plantar fascia, its echopattern, presence of hypoechoic areas, and perifasicular collections were recorded. SWE was done by placing seven ROIs within the plantar fascia; and the mean of their Young’s modulus was taken in kPa.
Results
Plantar fascial thickening more than 4 mm had 70% sensitivity and 66.7% specificity, echopattern had 90% sensitivity and 96.7% specificity, hypoechoic areas had 80% sensitivity and 96.7% specificity, and perifascial edema had 26.7% sensitivity and 100% specificity for diagnosing plantar fasciitis. Using the ROC curve, the cut-off value of Young’s modulus for the diagnosis of plantar fasciitis was found to be ≤ 99.286 kPa. This predicted plantar fasciitis with 97% sensitivity and 100% specificity. The primary diagnostic feature of ultrasound of plantar fascia thickness more than 4 mm detected 21 out of 30 cases of plantar fasciitis; whereas elastography detected an additional 8 cases which would have been missed on B-mode ultrasound alone.
Conclusions
SWE is a useful supplement and improves the diagnostic accuracy of gray-scale ultrasound in plantar fasciitis.
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All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by HYR, AS, and DKS. The first draft of the manuscript was written by NK, RC, and RKW. All authors read and approved the final manuscript.
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This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of University (Date: 29-Oct.-2018, IEC/VMMC/SJH/Thesis/October/2018-77)
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Ramu, H.Y., Sharma, A., Kumar, N. et al. Role of shear wave elastography in the diagnostic evaluation of plantar fasciitis: a prospective case–control study. J Ultrasound 26, 385–391 (2023). https://doi.org/10.1007/s40477-022-00694-z
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DOI: https://doi.org/10.1007/s40477-022-00694-z