Assessment of the Efficacy of Extracorporeal Shockwave Therapy for Plantar Fasciitis with Magnetic Resonance Imaging Findings

2018 ◽  
Vol 108 (2) ◽  
pp. 100-105 ◽  
Author(s):  
Mualla Bicer ◽  
Elif Hocaoglu ◽  
Sema Aksoy ◽  
Ercan İnci ◽  
İlknur Aktaş
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Plantar Fasciitis ◽  
Foot And Ankle ◽  
Resonance Imaging ◽  
Analog Scale ◽  
Mri Findings ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy

Background:Extracorporeal shockwave therapy (ESWT) has recently been used as a new treatment modality for plantar fasciitis. We aimed to determine the efficacy of ESWT by magnetic resonance imaging (MRI) findings.Methods:Thirty patients with plantar fasciitis who had received no treatment for 6 months were included. Extracorporeal shockwave therapy was applied once a week for a total of three sessions (frequency of 12–15 Hz, 2–3 bars, and 2,500 pulses). All of the patients were assessed with the visual analog scale, a 6-point evaluation scale, the Foot and Ankle Outcome Score (FAOS), and MRI findings before and 3 months after ESWT. Visual analog scale scores were used in determining the pain level of patients in the morning, during activity, and at rest. Foot and ankle–related problems were evaluated with the FAOS.Results:The duration of painless walking according to the 6-point rating scale, the FAOS, and pain showed significant improvements after ESWT (P < .05). Significant decreases in MRI findings, including thickening of the plantar fascia, soft-tissue edema, and bone marrow edema, were observed after treatment (P < .05).Conclusions:Extracorporeal shockwave therapy is a safe and effective treatment that yields favorable results in improvement of pain and function for plantar fasciitis. An MRI is useful for determining response to ESWT for these patients.

Treatment of Bone Marrow Edema of the Talus with Pulsed Electromagnetic Fields

2015 ◽  
Vol 105 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Nicolò Martinelli ◽  
Alberto Bianchi ◽  
Elena Sartorelli ◽  
Alessandra Dondi ◽  
Carlo Bonifacini ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Bone Marrow Edema ◽  
Foot And Ankle ◽  
Resonance Imaging ◽  
Analog Scale ◽  
Pulsed Electromagnetic ◽  
American Orthopaedic ◽  
Marrow Edema

Background Bone marrow edema (BME) of the talus is a rare, mostly self-limiting cause of foot and ankle pain. We sought to investigate in patients with idiopathic BME of the talus the effectiveness of pulsed electromagnetic fields and to determine the effect of this therapy on magnetic resonance imaging findings. Methods Six patients with BME of the talus confirmed by magnetic resonance imaging were enrolled. Pain was quantified with a visual analog scale from 0 (no pain) to 10 (the worst pain imaginable). The clinical outcome was assessed using the American Orthopaedic Foot and Ankle Society scoring system. Treatment consisted of pulsed electromagnetic field stimulation 8 h/d for 30 days. The device used generated pulses 1.3 milliseconds in duration, with a frequency of 75 Hz and a mean ± SD induced electric field of 3.5 ± 0.5 mV. Results The mean American Orthopaedic Foot and Ankle Society score improved from 59.4 (range, 40–66) before treatment to 94 (range, 80–100) at the last follow-up. The visual analog scale score decreased significantly from 5.6 (range, 4–7) before treatment to 1 (range, 0–2) at the last follow-up. Magnetic resonance imaging showed that BME improved after 1 month of treatment and resolved completely within 3 months in 5 patients, with normal signal intensity and no signs of progression to avascular necrosis. Conclusions A significant reduction in BME area was associated with a significant decrease in pain within 3 months of beginning treatment.

scholarly journals Anterior Talofibular Ligament Abnormalities on Routine Magnetic Resonance Imaging of the Ankle

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0003 ◽  
Author(s):  
Joseph O’Neil ◽  
Elizabeth McDonald ◽  
Talia Chapman ◽  
David Casper ◽  
Rachel Shakked ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Anterior Talofibular Ligament ◽  
Peroneal Tendon ◽  
Foot And Ankle ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Routine Magnetic Resonance Imaging ◽  
Orthopaedic Literature ◽  
Asymptomatic Individuals

Category: Ankle, Sports, Trauma Introduction/Purpose: The anterior talofibular ligament (ATFL) is one of the most commonly injured structures of the lower extremity after an ankle sprain. Evidence of remote injury to this structure is frequently encountered on magnetic resonance imaging (MRI) of the ankle, with uncertain clinical significance. Previous studies in the orthopaedic literature have discussed the prevalence of abnormal MRI findings in asymptomatic patients, most notably with regards to the spine and shoulder. More recently, a study on the prevalence of peroneal tendon abnormalities on routine MRI of the ankle was published. However, to our knowledge, no such study exists for the ATFL. The purpose of this study is to determine the prevalence of abnormal findings of the ATFL on MRI in asymptomatic individuals. Methods: All foot and ankle MRIs performed at our institution over a 4-month period were considered for inclusion in our study. Studies were excluded if performed on patients with documented ankle inversion injuries, ankle sprains, lateral ankle trauma, tenderness over the ATFL, or ankle instability. A total of 320 MRIs were eligible for inclusion. The integrity of the ATFL was noted in addition to the primary pathology. Results: The median age of the patients included in this study was 51 years with 203 females (63%) and 117 males (37%). One hundred eighteen (37%) of the 320 MRIs demonstrated some ATFL pathology. The most commonly encountered ATFL pathologies were thickening (38%), chronic tear (35%), attenuation (25%) and acute tear (2%). Conclusion: The results of this study demonstrate that a sizeable percentage of asymptomatic individuals (37%) will have ATFL abnormalities on magnetic resonance imaging of the foot and ankle. This study can have important clinical implications for patients who present with concerning MRI findings that do not correlate clinically. Based on our results, orthopaedic surgeons or any other physician providing musculoskeletal care can provide counseling and reassurance to patients who present with ATFL pathology on MRI but an absence of clinical findings. Much like MRI of the shoulder or spine, abnormalities must be correlated with the clinical exam.

scholarly journals Comparison of the effect of hyaluronic acid injection versus extracorporeal shockwave therapy on chronic plantar fasciitis: Protocol for a randomized controlled trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0250768
Author(s):  
Gabriel Ferraz Ferreira ◽  
Davy Sevilla ◽  
Carolinne Nascimento Oliveira ◽  
Luiz Carlos Nogueira Junior ◽  
Gustavo Gonçalves Arliani ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Statistical Analysis ◽  
Repeated Measures ◽  
Plantar Fasciitis ◽  
Foot And Ankle ◽  
Ultrasound Guided ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy ◽  
Significant Difference

Background Plantar fasciitis is the most common cause of pain in the plantar region of the heel, and extracorporeal shockwave therapy (ESWT) is an option used in cases where conservative treatment fails. Hyaluronic acid (HA), initially used for osteoarthrosis, is a treatment option because it has been applied to extra-articular regions, such as tendons, ligaments, and fascia. The aim of the present study will be to evaluate the outcomes of pain, function, and personal satisfaction after a single injection of HA and to compare the results with those of ESWT in patients with chronic plantar fasciitis. Methods The study will include 80 patients who will be randomized to receive three sessions of ESWT (n = 40) or a single ultrasound-guided HA injection in the plantar fascia (n = 40). The outcomes will include the visual analog pain scale score, American Orthopaedic Foot and Ankle Society (AOFAS) score, and Foot and Ankle Outcome Score (FAOS). All of the assessments will be performed at baseline and 3, 6, and 12 months after treatment. Statistical analysis will be performed using the repeated measures ANOVA (analysis of variance test) for primary and secondary outcomes and also Fisher’s Least Significant Difference, a Post-Hoc test. We will use R software for statistical analysis, randomization, and sample size calculation. Results Recruitment and data collection will begin in November 2020, with completion scheduled for November 2022 and final publication available in March 2023. Conclusion This trial will evaluate the effects of a single ultrasound-guided HA injection for the treatment of chronic plantar fasciitis. Trial registration Brazilian Clinical Trials Registry (Register Number: RBR-97vkx4) http://www.ensaiosclinicos.gov.br/rg/RBR-97vkx4/.

Correlation between the outcome of extracorporeal shockwave therapy and pretreatment MRI findings for chronic plantar fasciitis

2014 ◽  
Vol 25 (3) ◽  
pp. 427-430 ◽  
Author(s):  
Masahiro Maki ◽  
Kazuya Ikoma ◽  
Kan Imai ◽  
Masamitsu Kido ◽  
Yusuke Hara ◽  
...  
Keyword(s):  
Plantar Fasciitis ◽  
Mri Findings ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy

Surgical Correlation of Preoperative MRI Findings of Trauma to Tendons and Ligaments of the Foot and Ankle

2008 ◽  
Vol 98 (5) ◽  
pp. 370-373 ◽  
Author(s):  
Gerald T. Kuwada
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Lower Sensitivity ◽  
Posterior Tibial Tendon ◽  
Imaging Findings ◽  
Foot And Ankle ◽  
Resonance Imaging ◽  
Collateral Ligament ◽  
Mri Findings ◽  
Posterior Tibial

Background: The purpose of this study was to determine whether magnetic resonance imaging findings are accurate and can be confirmed surgically. Methods: Surgical correlation of preoperative magnetic resonance imaging findings of trauma to tendons and ligaments of the foot and ankle were retrospectively studied in 28 patients who had undergone surgical repair for tears of the Achilles tendon, posterior tibial tendon, peroneal tendons, collateral ligaments, and other pathology. Results: This study corroborates that magnetic resonance imaging findings are confirmed surgically 83% of the time for tears of tendons and ligaments of the foot and ankle. Larger tendons (Achilles, posterior tibial tendon) have a 94% sensitivity and 6% specificity, respectively. Collateral ligament and high ankle sprains have a 73% sensitivity. There is a lower sensitivity of 57% for peroneus brevis and longus ruptures. Conclusion: This study revealed that peroneal trauma can be an isolated event and in some cases can occur with other traumatic pathology such as collateral ligament tears. (J Am Podiatr Med Assoc 98(5): 370–373, 2008)

Comparison of High-Dose Extracorporeal Shockwave Therapy and Intralesional Corticosteroid Injection in the Treatment of Plantar Fasciitis

2010 ◽  
Vol 100 (2) ◽  
pp. 105-110 ◽  
Author(s):  
Istemi Yucel ◽  
Kutay Engin Ozturan ◽  
Yavuz Demiraran ◽  
Erdem Degirmenci ◽  
Gursel Kaynak
Keyword(s):  
Visual Analog Scale ◽  
Plantar Fasciitis ◽  
Therapeutic Response ◽  
Corticosteroid Injection ◽  
High Dose ◽  
Analog Scale ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy ◽  
Significant Difference

Background: The aim of this study was to evaluate the results of high-dose extracorporeal shockwave therapy applied with an ankle block and corticosteroid injection in patients with plantar fasciitis whose symptoms persisted for more than 6 months. Methods: Sixty patients were assessed clinically at presentation and at 3-month follow-up with a patient-assessed 100-mm visual analog scale of pain and a physician-assessed heel tenderness index. A therapeutic response rate was evaluated. A decrease of at least 50% from baseline to 3 months in visual analog scale or heel tenderness index scores was accepted as a successful result. Results: Extracorporeal shockwave therapy and corticosteroid injection provided significant improvements in visual analog scale and heel tenderness index scores, but between the two groups there was no significant difference in the visual analog scale score change 3 months after treatment (P > .05). Twenty-seven of 33 patients (82%) in the extracorporeal shockwave therapy group and 23 of 27 (85%) in the corticosteroid injection group had a successful therapeutic response after 3 months. Conclusions: Corticosteroid injection and extracorporeal shockwave therapy are successful treatment modalities for plantar fasciitis. Corticosteroid injection treatment is cost effective compared with extracorporeal shockwave therapy, and corticosteroid injection may be the first treatment choice according to these results. (J Am Podiatr Med Assoc 100(2): 105–110, 2010)

Computed Tomography and Magnetic Resonance Imaging-aided Diagnosis of Primary Essential Cutis Verticis Gyrata: A Case Report with 5-year Follow-up and Review of the Literature

2019 ◽  
Vol 15 (9) ◽  
pp. 906-910
Author(s):  
Hongzhang Zhu ◽  
Shi-Ting Feng ◽  
Xingqi Zhang ◽  
Zunfu Ke ◽  
Ruixi Zeng ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Three Dimensional ◽  
Stable Condition ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Cutis Verticis Gyrata ◽  
Essential Form ◽  
History Of ◽  
Magnetic Resonance Imaging Mri

Background: Cutis Verticis Gyrata (CVG) is a rare skin disease caused by overgrowth of the scalp, presenting as cerebriform folds and wrinkles. CVG can be classified into two forms: primary (essential and non-essential) and secondary. The primary non-essential form is often associated with neurological and ophthalmological abnormalities, while the primary essential form occurs without associated comorbidities. Discussion: We report on a rare case of primary essential CVG with a 4-year history of normal-colored scalp skin mass in the parietal-occipital region without symptom in a 34-year-old male patient, retrospectively summarizing his pathological and Computer Tomography (CT) and magnetic resonance imaging (MRI) findings. The major clinical observations on the CT and MR sectional images include a thickened dermis and excessive growth of the scalp, forming the characteristic scalp folds. With the help of CT and MRI Three-dimensional (3D) reconstruction techniques, the characteristic skin changes could be displayed intuitively, providing more evidence for a diagnosis of CVG. At the 5-year followup, there were no obvious changes in the lesion. Conclusion: Based on our observations, we propose that not all patients with primary essential CVG need surgical intervention, and continuous clinical observation should be an appropriate therapy for those in stable condition.

scholarly journals Balo’s Concentric Sclerosis Mimicking Tumor on Magnetic Resonance Imaging in a Young Patient

2021 ◽  
Vol 14 ◽  
pp. 117954762198967
Author(s):  
Van Trung Hoang ◽  
Cong Thao Trinh ◽  
Hoang Anh Thi Van ◽  
Thanh Tam Thi Nguyen ◽  
Vichit Chansomphou ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Demyelinating Disease ◽  
Management Strategies ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Demyelinating Lesions ◽  
Baló’S Concentric Sclerosis ◽  
Magnetic Resonance Imaging Mri ◽  
Subcortical Regions

Balo’s concentric sclerosis (BCS) is a rare demyelinating disease known as Multiple Sclerosis (MS) lesion type III. It is a disease of the white matter of the brain characterized by a round lesion with variable concentric myelinated and demyelinated layers, appearing as “onion bulb.” We present a case of BCS and discuss the imaging findings and management strategies of this disease. A 26-y-old male developed headache, weakness, and numbness of limbs. Magnetic resonance imaging (MRI) showed concentric lamellar like demyelinating lesions at the subcortical regions. The patient’s neurological symptoms were consistent with the MRI findings.

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