Sonographic Evaluation and Conservative Treatment of Plantar Fasciitis / 대한정형외과학회잡지

ABSTRACT

PURPOSE: We report the differences of the clinical outcome of various types of plantar fasciitis patients who were treated with conservative methods, and their sonographic findings. MATERIALS AND METHODS: 37 patients, 50 cases with the diagnosis of plantar fasciitis were available for review. The average age was 47.5 years (range 22-78) and the average follow-up period was 15.8 months (range 4-23) . Both feet of 30 plantar fasciitis patients and those of 30 healthy volunteers were evaluated with ultrasound. We treated the patients with stretching of Achilles tendon and plantar fascia, rest, nonsteroidal anti-inflammatory drugs, inserts and night splint. RESULTS: Clinical results were classified as good (resolution of symptoms) for 59.5%, fair (continued symptoms but no limitation of activity or work) for 35.1%, and poor (continued symptoms limiting activity or changing work status) for 5.4%. Plantar fascia thickness was significantly greater in the heels of patients with plantar fasciitis (range 3.2-8.0 mm, average 5.1 mm, SD 1.12) than in their asymptomatic heels (range 1.3-5.0 mm, average 3.5 mm, SD 0.78) and in the control group (range 1.8-5.0 mm, average 3.0 mm, SD 0.71) (p< 0.0001) . CONCLUSION: In plantar fasciitis, sonography demonstrates that the fascia is thicker as well as hypoechoic. And there is a higher risk for continued symptoms in patients with bilateral symptoms and those who have symptoms for a prolonged period before seeking medical attention. Therefore plantar fasciitis is thought that it should be vigorously treated as soon as possible before the permanent change of plantar fascia.