Is 2D SWE sufficient as clinical diagnosis in patients with plantar fasciitis?

2021 ◽  
pp. 028418512110589
Author(s):  
Engin Beydoğan ◽  
Atilla Yalçın
Keyword(s):  
Plantar Fasciitis ◽  
Shear Wave Elastography ◽  
Plantar Fascia ◽  
Thickness Measurement ◽  
Clinical Findings ◽  
Imaging Method ◽  
Control Groups ◽  
Measurement Results ◽  
Healthy Control ◽  
Foot Function

Background The use of shear wave elastography (SWE) seems to be an important imaging method in the diagnosis of plantar fasciitis (PF). Purpose To compare patients diagnosed with PF with similar and young healthy control groups in terms of B-mode ultrasound (US) and SWE results and to evaluate the elasticity of the plantar fascia. Material and Methods A total of 140 feet of 70 participants were evaluated, including 30 patients and 40 healthy individuals as the control. Clinical, B-mode US, and SWE evaluations were performed for each patient. In addition, American Orthopedic Foot and Ankle Score (AOFAS) was calculated to evaluate pain and foot function in both groups. Results Of the patients in the PF group, 40 (88%) were women and the healthy control groups had similar sex distributions ( P = 0.23). The AOFAS score was lower in feet with PF compared to the other groups ( P < 0.001). Of 30 patients with PF, 15 (50%) had bilateral PF and 15 (50%) unilateral PF. In addition, ≥4 mm thickness measurement, which was used as a diagnostic criterion for PF as a US finding, could be shown in 11 (73.3%) patients with unilateral PF and 6 (40%) patients with bilateral PF. Conclusion In conclusion, the evaluation of the diagnosis of PF with clinical findings and regular follow-up of measurements with SWE can provide measurement results with higher sensitivity in the diagnosis of PF.

scholarly journals Shear Wave Elastography of the Plantar Fascia: Comparison between Patients with Plantar Fasciitis and Healthy Control Subjects

2021 ◽  
Vol 10 (11) ◽  
pp. 2351
Author(s):  
Daniel Baur ◽  
Christoph Schwabl ◽  
Christian Kremser ◽  
Mihra S. Taljanovic ◽  
Gerlig Widmann ◽  
...  
Keyword(s):  
Shear Wave ◽  
Healthy Subjects ◽  
Plantar Fasciitis ◽  
Color Doppler ◽  
Shear Wave Elastography ◽  
Plantar Fascia ◽  
Thickness Measurement ◽  
Institutional Review Boards ◽  
Institutional Review ◽  
Healthy Control

Background: The purpose of this study was to evaluate plantar fasciae of healthy subjects and patients with plantar fasciitis by shear wave velocity (SWV) and stiffness with correlation to B-Mode and color Doppler ultrasonography (CDUS) and to establish cut-off values. Methods: This observational study was conducted with the approval of the Institutional Review Boards (IRBs) of our institution. 108 unilateral plantar fasciae were evaluated by including 87 consecutive patients (mean age 51.7; range: 29–82) (66 women and 21 men) with plantar fasciitis and 21 asymptomatic age matched healthy volunteers (mean age 47.3; range: 32–58) (15 women and 6 men). All patients were prospectively imaged between July 2018 and March 2019. B-mode US was used to measure thickness and CDUS to grade vascularity. SWE measurements were repeated 3 times and mean was used for statistical analysis. Results: Mean SWV value in healthy subjects was 6.94 m/s and in patients 4.98 m/s with a mean stiffness value of 152.88 kPa and 93.54 kPa respectively (p < 0.001). For SWV a cut-off value of 6.16 m/s had a specificity of 80.95% and sensitivity of 79.31%. For stiffness a cut-off value of 125.57 kPa had a specificity of 80.95% and sensitivity of 80.46%. No correlation to CDUS was found. The mean thickness of healthy fascias was 3.3 mm (range 2.4–3.9) compared to 6.1 mm (range 2.0–22.0) in plantar fasciitis (p < 0.001) with no correlation to SWV or to stiffness (r² = 0.02, p = 0.06). Conclusion: SWE allows quantitative assessment of plantar fascia stiffness, which decreases in patients with plantar fasciitis. No correlation to the thickness of the plantar fascia was found, therefore it represents an independent factor for the diagnosis of plantar fasciitis and could be helpful in addition to thickness measurement in unclear cases.

scholarly journals Real-time Sonoelastography of the Plantar Fascia: Comparison between Patients with Plantar Fasciitis and Healthy Control Subjects

Radiology ◽  
2013 ◽  
Vol 267 (1) ◽  
pp. 195-200 ◽  
Author(s):  
Luca Maria Sconfienza ◽  
Enzo Silvestri ◽  
Davide Orlandi ◽  
Emanuele Fabbro ◽  
Giulio Ferrero ◽  
...  
Keyword(s):  
Real Time ◽  
Plantar Fasciitis ◽  
Plantar Fascia ◽  
Control Subjects ◽  
Healthy Control

scholarly journals Comparative study of functional outcome between plantar fascia stretching and achilles tendon stretching exercises in choronic plantar fasciitis

2015 ◽  
Vol 3 (2) ◽  
pp. 84-88
Author(s):  
S Shrestha ◽  
S Rai ◽  
H Limbu ◽  
S Bajracharya
Keyword(s):  
Achilles Tendon ◽  
Functional Outcome ◽  
Plantar Fasciitis ◽  
Weight Bearing ◽  
Plantar Fascia ◽  
Foot Function Index ◽  
Function Index ◽  
Pain Subscale ◽  
Foot Function ◽  
Stretching Exercises

Background: Plantar fasciitis is a self limiting disease, with only 10% of patient developing chronic condition even after ten months. We hypothesized that patient with chronic plantar fasciitis who are treated with standard plantar fascia stretching program can have a better functional outcome than those treated with Achilles tendon-stretching exercise.Method: Forty patients who had chronic plantar fasciitis for duration of at least ten months were randomized into one of two groups. Group A received plantar stretching exercise and Group B had Achilles tendon stretching program. All patients completed the pain subscale of Foot Function Index and a subject relevant outcome survey that incorporated generic and condition-specific outcome measures related to pain, function and satisfaction with treatment outcome.Result: The pain subscale scores of the Foot Function Index showed significantly better results at eight weeks for the patients managed with plantar fascia stretching program respect to item 1 (worst pain; p = 0.004) and item 2 (first steps in the morning; p =0.001). Similarly at ten months follow up, pain subscale score comparison was statistically significant for item 1 (p = 0.018) and item 2 (p =0.003).Conclusions: A treatment method of non-weight-bearing stretching exercises specific to plantar fascia is superior to the conventional method of weight-bearing Achilles tendon-stretching exercises for treating patients with chronic plantar fasciitis.Nepal Journal of Medical Sciences Vol.3(2) 2014: 84-88

scholarly journals Elasticity of the Achilles Tendon in Individuals With and Without Plantar Fasciitis: A Shear Wave Elastography Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Weiyi Pan ◽  
Jiping Zhou ◽  
Yuyi Lin ◽  
Zhijie Zhang ◽  
Yulong Wang
Keyword(s):  
Achilles Tendon ◽  
Elastic Properties ◽  
Plantar Fasciitis ◽  
Mechanical Load ◽  
Shear Wave Elastography ◽  
Plantar Fascia ◽  
Neutral Position ◽  
Passive Stiffness ◽  
Cross Sectional ◽  
Tendon Stiffness

The elastic properties of the Achilles tendon (AT) are altered in local injury or other diseases and in response to changes in mechanical load. Recently, elastography has been used to evaluate variations in tendon elastic properties, mainly among healthy individuals or athletes. Therefore, this study evaluated the biomechanical changes in ATs in individuals with and without plantar fasciitis (PF). The purposes were as follows: (1) to evaluate the passive stiffness of three regions of the AT which defined as 0 (AT0 cm), 3 (AT3 cm), and 6 cm (AT6 cm) above the calcaneal tuberosity in participants with and without PF, (2) to investigate the interplay between the passive stiffness in patients with PF and pain, (3) to detect optimal cut-off points of stiffness of the AT in assessing individuals with chronic PF, and (4) to determine the correlation between the plantar fascia thickness (PFT) and pain. This cross-sectional study included 40 participants (mean age = 51 ± 13 years). When the ankle was in a relaxed position, patients with PF experienced increased passive stiffness in AT0 cm (p = 0.006) and AT3 cm (P = 0.003), but not in the neutral position. Significant correlations were observed between pain and stiffness of AT (AT0 cm r = 0.489, P = 0.029; AT3 cm r = 487, P = 0.030; AT6 cm r = 0.471, P = 0.036), but not in the PFT (P = 0.557). Optimal cut-off stiffness was AT (452 kPa) in the relaxed ankle position. The plantar fascia of patients with PF was significantly thicker than that of the controls (P &lt; 0.001). Findings from the present study demonstrate that tendon stiffness is a good indicator of the clinical situation of patients with PF. Monitoring passive tendon stiffness may provide additional information to assess severity of the condition and guide therapeutic. The treatment programs for PF should also be tailored to the distal AT, as conventional therapy might not be targeted to tight tendons.

scholarly journals Effect of Myofascial Release Therapy In Addition To K-Tape on Chronic Plantar Fasciitis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
P k Tamil Nidhi ◽  
D Anandhan ◽  
B Arun ◽  
K Anantharaj
Keyword(s):  
Pain Score ◽  
Plantar Fasciitis ◽  
Tamil Nadu ◽  
Plantar Fascia ◽  
Heel Pain ◽  
Control Group ◽  
Myofascial Release ◽  
Foot Function Index ◽  
Function Index ◽  
Foot Function

Plantar fasciitis is one of the most common cause of heel pain. Injury to the plantar fascia results in loss of normally resilient in fascia. Fascia becomes stiffened and prone to re-injury, which resulting in a vicious cycle of persistent pain and inflammation. Though many therapies would produce better results, there was less exploration on fascial release therapy and k-tape. The purpose of the study is to identify the effect of MFR in addition to K-tape on chronic plantar fasciitis. This is a Quasi-experimental study with 48 participants. The ethical approval was obtained and the study was conducted in multiple physiotherapy centers in Namakkal district, Tamil Nadu. All the participants were selected based on selection criteria mainly those who fulfil any of the three from below, 1) Heel pain increases in the morning with first few steps following prolonged bed rest 2) Pain localized to the inferior heel 3) Pain decreases with activity such as walking or moving 4) Pain score is between 3—7 cms in 10 cm VAS. 24 participants in the experimental group receive myofascial release therapy along with k-tape for 6 weeks, 24 participants in the control group receive stretching along with k-tape for 6 weeks. The outcome measures used in this study are pain and foot function by numerical pain scale and foot function index respectively. Results were analyzed using SPSS 20.0, the results show that there were significant differences obtained between the myofascial release therapy with the k-tape group when compared to k- tape only group. There was a pain score of 10.82 ± 0.196 (p < 0.001) and foot function index score of 10.6 ± 3.85 (p < 0.001). This study concluded that the use of Myofascial release therapy with K-tape reduces pain scores and improves foot function in plantar fasciitis.

Effectiveness of Calf Stretching Exercises Versus Plantar Fascia Stretching Exercises in Plantar Fasciitis: An Experimental Study

2020 ◽  
Vol 11 (2) ◽  
pp. 890
Author(s):  
Jasneet S. Chawla ◽  
Manjeet Singh ◽  
Ashwani Ummat ◽  
Manu Goyal ◽  
Harsimarjit Kaur ◽  
...  
Keyword(s):  
Experimental Study ◽  
Plantar Fasciitis ◽  
Plantar Fascia ◽  
Stretching Exercises

scholarly journals VEGF as a potential molecular target in periodontitis: a meta-analysis and microarray data validation

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Bo Ren ◽  
Que Feng ◽  
Shan He ◽  
Yanfeng Li ◽  
Jiadong Fan ◽  
...  
Keyword(s):  
Growth Factor ◽  
Clinical Sample ◽  
Meta Analysis ◽  
Enrichment Analysis ◽  
Therapeutic Drug ◽  
Data Validation ◽  
Control Groups ◽  
Vegf Expression ◽  
Healthy Control

Abstract Background Anti-vascular endothelial growth factor (VEGF) has been used as a therapeutic drug for the treatment of some human diseases. However, no systematic evidence is performed for assessing the role of VEGF in periodontitis. We carried out a comprehensive analysis to explore the role of VEGF in patients with periodontitis. Methods Multiple databases were searched for eligible studies. The pooled standardized mean difference (SMD) and odds ratio (OR) with the corresponding 95% confidence interval (CI) were applied to evaluate the effect sizes. Clinical data validation from microarray analysis was used. Pathway and process enrichment analysis were also investigated. Results Finally, 16 studies were included in this analysis. Overall, there was a significantly higher level of VEGF expression in periodontitis than in healthy control groups (OR = 16.64, 95% CI = 6.01–46.06, P < 0.001; SMD = 2.25, 95% CI = 1.25–3.24, P < 0.001). Subgroup analysis of ethnicity showed that VEGF expression was still correlated with periodontitis in the Asian and European populations. No correlation was observed between VEGF expression and age, gender, and pathological type. A large clinical sample data (427 periodontitis patients and 136 healthy controls) further validated that VEGF expression was higher in periodontitis than in healthy control groups (P = 0.023). VEGF was involved in many functions such as blood vessel development, response to growth factor, cell proliferation, and cell adhesion. Conclusions High levels of VEGF were credible implications for the development of periodontitis. Anti-VEGF therapy may be valuable for the treatment of periodontitis in clinical management.

Ultrasound-Guided Injection of Dextrose Versus Corticosteroid in Chronic Plantar Fasciitis Management: A Randomized, Double-Blind Clinical Trial

2021 ◽  
pp. 193864002098092
Author(s):  
Gholamreza Raissi ◽  
Amin Arbabi ◽  
Maryam Rafiei ◽  
Bijan Forogh ◽  
Arash Babaei-Ghazani ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Plantar Fasciitis ◽  
Rating Scale ◽  
Corticosteroid Injection ◽  
Treatment Options ◽  
Plantar Fascia ◽  
Numeric Rating Scale ◽  
Therapeutic Effects ◽  
Ultrasound Guided ◽  
Double Blind

Design Chronic plantar fasciitis (PF) is a common cause of chronic heel pain, with different conventional treatment options. In this randomized clinical trial, the effect of ultrasound-guided injection of dextrose versus corticosteroid in chronic PF was evaluated and compared. Methods A total of 44 patients suffering from chronic PF who visited the physical medicine and rehabilitation clinic were enrolled in the study. Two table-randomized groups were formed. They received an ultrasonography-guided, single injection of either 40 mg methylprednisolone or 20% dextrose. Numeric Rating Scale (NRS), Foot and Ankle Ability Measure questionnaire with 2 subscales, Activities of Daily Living (FAAM-A) and Sports (FAAM-S), along with ultrasonographic parameters were evaluated before and at 2 and 12 weeks after the injection. Results. A total of 40 participants completed the study. Both interventions significantly improved pain and function at 2 and 12 weeks postinjection. After 2 weeks, compared with the dextrose prolotherapy, the corticosteroid group had significantly lower daytime and morning NRS scores (2.55 vs 4.1, P = .012, and 2.75 vs 4.65, P = .004), higher FAAM-S (66.84 vs 54.19; P = .047), and lower plantar fascia thickness at insertion and 1 cm distal to the insertion zone (3.89 vs 4.29 mm, P = .004, and 3.13 vs 3.48 mm, P = .002), whereas FAAM-A was similar in both groups ( P = .219). After 12 weeks, all study variables were statistically similar between corticosteroid and dextrose prolotherapy groups. No injection-related side effects were recorded in either group. Conclusion Both methods are effective. Compared with dextrose prolotherapy, our results show that corticosteroid injection may have superior therapeutic effects early after injection, accompanied by a similar outcome at 12 weeks postinjection. Levels of Evidence: Level II

scholarly journals Mechanical ventilation-induced alterations of intracellular surfactant pool and blood–gas barrier in healthy and pre-injured lungs

2020 ◽  
Author(s):  
Jeanne-Marie Krischer ◽  
Karolin Albert ◽  
Alexander Pfaffenroth ◽  
Elena Lopez-Rodriguez ◽  
Clemens Ruppert ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Blood Gas ◽  
Control Groups ◽  
Gas Barrier ◽  
Alveolar Epithelial ◽  
Alveolar Surfactant ◽  
Healthy Control ◽  
Mean Size ◽  
The Mean ◽  
Injury Progression

AbstractMechanical ventilation triggers the manifestation of lung injury and pre-injured lungs are more susceptible. Ventilation-induced abnormalities of alveolar surfactant are involved in injury progression. The effects of mechanical ventilation on the surfactant system might be different in healthy compared to pre-injured lungs. In the present study, we investigated the effects of different positive end-expiratory pressure (PEEP) ventilations on the structure of the blood–gas barrier, the ultrastructure of alveolar epithelial type II (AE2) cells and the intracellular surfactant pool (= lamellar bodies, LB). Rats were randomized into bleomycin-pre-injured or healthy control groups. One day later, rats were either not ventilated, or ventilated with PEEP = 1 or 5 cmH2O and a tidal volume of 10 ml/kg bodyweight for 3 h. Left lungs were subjected to design-based stereology, right lungs to measurements of surfactant proteins (SP−) B and C expression. In pre-injured lungs without ventilation, the expression of SP-C was reduced by bleomycin; while, there were fewer and larger LB compared to healthy lungs. PEEP = 1 cmH2O ventilation of bleomycin-injured lungs was linked with the thickest blood–gas barrier due to increased septal interstitial volumes. In healthy lungs, increasing PEEP levels reduced mean AE2 cell size and volume of LB per AE2 cell; while in pre-injured lungs, volumes of AE2 cells and LB per cell remained stable across PEEPs. Instead, in pre-injured lungs, increasing PEEP levels increased the number and decreased the mean size of LB. In conclusion, mechanical ventilation-induced alterations in LB ultrastructure differ between healthy and pre-injured lungs. PEEP = 1 cmH2O but not PEEP = 5 cmH2O ventilation aggravated septal interstitial abnormalities after bleomycin challenge.

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