Top

Archives of Orthopaedic and Trauma Surgery

Published in:

01-05-2009 | Orthopaedic Outcome Assessment

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

Authors: Istemi Yucel, Burhan Yazici, Erdem Degirmenci, Besir Erdogmus, Semih Dogan

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 5/2009

Abstract

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.

Akfirat M, Sen C, Gunes T (2003) Ultrasonographic appearance of the plantar fasciitis. Clin Imaging 27:353–357PubMedCrossRef

Barry LD, Barry AN, Chen Y (2002) A retrospective study of standing gastrocnemius-soleus stretching versus night splinting in the treatment of plantar fasciitis. J Foot Ankle Surg 41:221–227PubMedCrossRef

Buchbinder R (2004) Clinical practice. Plantar fasciitis. N Engl J Med 350:2159–2166PubMedCrossRef

Cardinal E, Chhem RK, Beauregard CG et al (1996) Plantar fasciitis: sonographic evaluation. Radiology 201:257–259PubMed

Cheung JT, Zhang M, An KN (2004) Effects of plantar fascia stiffness on the biomechanical responses of the ankle-foot complex. Clin Biomech (Bristol, Avon) 19:839–846CrossRef

Dasgupta B, Bowles J (1995) Scintigraphic localisation of steroid injection site in plantar fasciitis. Lancet 346:1400–1401PubMedCrossRef

DiGiovanni BF, Nawoczenski DA, Lintal ME et al (2003) Tissue-specific plantar fascia-stretching exercise enhances outcomes in patients with chronic heel pain. A prospective, randomized study. J Bone Joint Surg Am 85-A:1270–1277PubMed

Evans A (2001) Podiatric medical applications of posterior night stretch splinting. J Am Podiatr Med Assoc 91:356–360PubMed

Fuller EA (2000) The windlass mechanism of the foot. A mechanical model to explain pathology. J Am Podiatr Med Assoc 90:35–46PubMed

10.

Garrow JS, Webster J (1985) Quetelet’s index (W/H2) as a measure of fatness. Int J Obes 9:147–153PubMed

11.

Genc H, Saracoglu M, Nacir B et al (2005) Long-term ultrasonographic follow-up of plantar fasciitis patients treated with steroid injection. Joint Bone Spine 72:61–65PubMedCrossRef

12.

Gill LH, Kiebzak GM (1996) Outcome of nonsurgical treatment for plantar fasciitis. Foot Ankle Int 17:527–532PubMed

13.

Hammer DS, Adam F, Kreutz A et al (2005) Ultrasonographic evaluation at 6-month follow-up of plantar fasciitis after extracorporeal shock wave therapy. Arch Orthop Trauma Surg 125:6–9PubMedCrossRef

14.

Hyer CF, Vancourt R, Block A (2005) Evaluation of ultrasound-guided extracorporeal shock wave therapy (ESWT) in the treatment of chronic plantar fasciitis. J Foot Ankle Surg 44:137–143PubMedCrossRef

15.

Intenzo CM, Wapner KL, Park CH et al (1991) Evaluation of plantar fasciitis by three-phase bone scintigraphy. Clin Nucl Med 16:325–328PubMedCrossRef

16.

Kamel M, Kotob H (2000) High frequency ultrasonographic findings in plantar fasciitis and assessment of local steroid injection. J Rheumatol 27:2139–2141PubMed

17.

Kane D, Greaney T, Bresnihan B et al (1998) Ultrasound guided injection of recalcitrant plantar fasciitis. Ann Rheum Dis 57:383–384PubMedCrossRef

18.

Kane D, Greaney T, Shanahan M et al (2001) The role of ultrasonography in the diagnosis and management of idiopathic plantar fasciitis. Rheumatology (Oxford) 40:1002–1008CrossRef

19.

Kogler GF, Solomonidis SE, Paul JP (1995) In vitro method for quantifying the effectiveness of the longitudinal arch support mechanism of a foot orthosis. Clin Biomech (Bristol, Avon) 10:245–252CrossRef

20.

Landorf KB, Keenan AM, Herbert RD (2004) Effectiveness of different types of foot orthoses for the treatment of plantar fasciitis. J Am Podiatr Med Assoc 94:542–549PubMed

21.

Lemont H, Ammirati KM, Usen N (2003) Plantar fasciitis: a degenerative process (fasciosis) without inflammation. J Am Podiatr Med Assoc 93:234–237PubMed

22.

Ozdemir H, Yilmaz E, Murat A et al (2005) Sonographic evaluation of plantar fasciitis and relation to body mass index. Eur J Radiol 54:443–447PubMedCrossRef

23.

Placzek R, Deuretzbacher G, Buttgereit F et al (2005) Treatment of chronic plantar fasciitis with botulinum toxin A: an open case series with a 1 year follow up. Ann Rheum Dis 64:1659–1661PubMedCrossRef

24.

Porter MD, Shadbolt B (2005) Intralesional corticosteroid injection versus extracorporeal shock wave therapy for plantar fasciopathy. Clin J Sport Med 15:119–124PubMedCrossRef

25.

Richardson EG (1999) Heel pain. In: Coughlin MJ, Mann R (eds) Surgery of the foot and ankle. Mosby, St Louis, p 862

26.

Riddle DL, Pulisic M, Pidcoe P et al (2003) Risk factors for plantar fasciitis: a matched case–control study. J Bone Joint Surg Am 85-A:872–877PubMed

27.

Riddle DL, Pulisic M, Sparrow K (2004) Impact of demographic and impairment-related variables on disability associated with plantar fasciitis. Foot Ankle Int 25:311–317PubMed

28.

Riddle DL, Schappert SM (2004) Volume of ambulatory care visits and patterns of care for patients diagnosed with plantar fasciitis: a national study of medical doctors. Foot Ankle Int 25:303–310PubMed

29.

Rose JD, Malay DS, Sorrento DL (2003) Neurosensory testing of the medial calcaneal and medial plantar nerves in patients with plantar heel pain. J Foot Ankle Surg 42:173–177PubMedCrossRef

30.

Sabir N, Demirlenk S, Yagci B et al (2005) Clinical utility of sonography in diagnosing plantar fasciitis. J Ultrasound Med 24:1041–1048PubMed

31.

Tsai WC, Hsu CC, Chen CP et al (2006) Plantar fasciitis treated with local steroid injection: comparison between sonographic and palpation guidance. J Clin Ultrasound 34:12–16PubMedCrossRef

32.

Tsai WC, Wang CL, Tang FT et al (2000) Treatment of proximal plantar fasciitis with ultrasound-guided steroid injection. Arch Phys Med Rehabil 81:1416–1421PubMedCrossRef

33.

Tudor GR, Finlay D, Allen MJ et al (1997) The role of bone scintigraphy and plain radiography in intractable plantar fasciitis. Nucl Med Commun 18:853–856PubMedCrossRef

34.

Vohra PK, Kincaid BR, Japour CJ et al (2002) Ultrasonographic evaluation of plantar fascia bands. A retrospective study of 211 symptomatic feet. J Am Podiatr Med Assoc 92:444–449PubMed

35.

Walther M, Radke S, Kirschner S et al (2004) Power Doppler findings in plantar fasciitis. Ultrasound Med Biol 30:435–440PubMedCrossRef

36.

Wong SM, Li E, Griffith JF (2001) Ultrasound guided injection of plantar fasciitis. Ann Rheum Dis 60:639PubMedCrossRef

Title: Comparison of ultrasound-, palpation-, and scintigraphy-guided steroid injections in the treatment of plantar fasciitis
Authors: Istemi Yucel
Burhan Yazici
Erdem Degirmenci
Besir Erdogmus
Semih Dogan
Publication date: 01-05-2009
Publisher: Springer-Verlag
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 5/2009
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-008-0760-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 5/2009

Revision of failed acetabular components utilizing a cementless oblong cup: an average 9-year follow-up study

Orthopaedic training worldwide: how they compare? A pilot study

Severe subluxation of the femoral head after rotational acetabular osteotomy: a case report

Contrast-enhanced MR imaging of subchondral insufficiency fracture of the femoral head: a preliminary comparison with that of osteonecrosis of the femoral head

Gains and losses of small incision lateral total hip arthroplasty: what the patients want and its index case result

Neutrophils in frozen section and type of microorganism isolated at the time of resection arthroplasty for the treatment of infection