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

Ruolo dell’ecografia ad elevata risoluzione nella guida al trattamento della fascite plantare idiopatica con tecniche mini-invasive

  • Musculoskeletal Radiology/Radiologia Muscolo-Scheletrica
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

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.

Riassunto

Obiettivo

Valutare l’affidabilità del criterio ecografico nell’individuazione dell’edema perifasciale nella scelta della terapia mini-invasiva (iniezione di corticosteroidi o onde d’urto, ESWT) con guida dell’ecografia ad alta risoluzione (HRUS) nel trattamento della fascite plantare idiopatica (FPI).

Materiali e metodi

Sessantaquattro pazienti con diagnosi clinica di FPI monolaterale, recalcitrante, trattata conservativamente per almeno 8 settimane, sono stati sottoposti ad HRUS. Il dolore è stato quantizzato con una visual analogue scale (VAS). La FPI è stata verificata all’HRUS ed è stata valutata la presenza di edema perifasciale. I pazienti con diagnosi HRUS di FPI sono stati suddivisi in (A) presenza e (B) assenza di edema perifasciale e poi suddivisi random in trattati con (1) infiltrazione di corticosteroidi e (2) ESWT. Le rivalutazioni clinica e HRUS sono state eseguite a 6 settimane.

Risultati

Nel 68,97% dei pazienti l’HRUS ha evidenziato una FPI con edema perifasciale nel 53,33%. Nei pazienti dei sottogruppi A1 e A2 è stato evidenziato un miglioramento clinico-strumentale nel 87,5% e nel 37,5% dei casi, mentre nei pazienti dei sottogruppi B1 e B2 questo è stato evidenziato nel 35,71% e nel 92,85% dei casi.

Conclusioni

La presenza dell’edema perifasciale potrebbe essere un efficace criterio nell’indirizzare la terapia verso le iniezioni di corticosteroidi con guida HRUS.

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Authors and Affiliations

  1. DIBIMEL, Sezione di Scienze Radiologiche, Università degli Studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy

    F. Sorrentino, A. Iovane, A. Vaccari & M. Midiri

  2. Centro Medico Mantia, Via De Spuches 22, 90100, Palermo, Italy

    A. Vetro & R. Mantia

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  1. F. Sorrentino
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  2. A. Iovane
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  3. A. Vetro
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  4. A. Vaccari
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  5. R. Mantia
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  6. M. Midiri
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Correspondence to F. Sorrentino.

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Sorrentino, F., Iovane, A., Vetro, A. et al. Role of high-resolution ultrasound in guiding treatment of idiopathic plantar fasciitis with minimally invasive techniques. radiol med 113, 486–495 (2008). https://doi.org/10.1007/s11547-008-0277-2

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  • DOI: https://doi.org/10.1007/s11547-008-0277-2

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