Objective. To evaluate the intra- and inter-operator reliability of me
asuring weightbearing heel pad thickness in healthy subjects. Backgrou
nd. Heel pad thickness has been reported to be an important factor in
determining stresses observed in healthy as well as pathological feet.
To date no published data are available on inter- and intra-operator
variation in sonographic heel pad thickness measurements in adults. Me
thod. bilateral heel pad thickness was measured in 10 adult subjects,
with no history of plantar heel pain, by two experienced operators, on
two separate occasions. Limits of agreement for three replicate measu
rements by each ultrasonographer and for replicate measurements were d
etermined. Results. Replicate heel pad thickness measurements in 95% o
f cases differ by less than 0.39 mm, and the magnitude of variations i
s similar when measurements are made by either single or different ult
rasonographers, and were similar for right and left heel pad thickness
measurements. Between scan measurements demonstrated a coefficient of
variation of 3.2%. Conclusion. Weightbearing heel pad thickness measu
rements by ultrasound using a standardised technique in normal adult f
eet are reasonably reliable.