High frequency ultrasonographic findings in plantar fasciitis and assessment of local steroid injection

Objective. To investigate the value of ultrasonography in the diagnosis of plantar fasciitis and changes in plantar fascia following ultrasound guided local steroid injection. Methods. Twenty patients with a clinical diagnosis of planter fasciitis and 20 healthy subjects were studied prospectively. Ultrasound examination was performed using an ATL Apogee 800 and linear an ay 11 MHz transducer, The affected heel was injected with 15 mg triamcinolone hexacetonide and 2 mi o f 2% lidocaine, Ultrasound examination was performed at time of clinical ev aluation, again immediately after injection, and at 1, 6, and 30 weeks late r. The thickness, echogenicity, and marginal appearance of planter fascia w ere measured. Results. Ultrasonographic measurement of plantar fascia showed a significan t increase in symptomatic heels (range 4.8-6.5, mean 5.8 +/- 2.06 mm) compa red with healthy subjects (range 1.8-3.4, mean 2.4 +/- 0.64 mm) (p < 0.001) , A significant decrease in the thickness of plantar fascia was observed 1 week after local steroid injection (range 2.1-3.5, mean 2.3 +/- 0.91 mm), C omplete relief of symptoms and signs was further observed at 6 and 30 weeks . Conclusion. Ultrasonographic examination of plantar fascia is easy and quic k to perform. Ultrasound procedure should be considered early in diagnosis and management of heel pain, Ultrasound guided local steroid injection prov ed safe and effective in the treatment of plantar fasciitis.