Ultrasound evaluation of plantar fasciitis

Objective: To investigate the sonographic features of plantar fasciitis (PF ). Methods.. High-resolution ultrasound was used to measure the thickness and echogenicity of the proximal plantar fascia and associated heel Dad thickne ss for 102 consecutive patients with PF (unilateral: 81, bilateral: 21) and 33 control subjects. Results: The mean thickness of the plantar fascia was greater on the sympto matic side for patients with bilateral and unilateral PF than on the asympt omatic side for patients with unilateral PF, and also control subjects (5.4 7+/-1.09, 5.61+/-1.19, 3.83+/-0.72, 3.19+/-0.43 mm, respectively, p<0.001). A substantial difference in thickness between the asymptomatic side of pat ients with unilateral PF and control subjects was also noted (p=0.001). The heel pad thickness was not show different between control subjects and pat ients with PF. The incidence of hypoechoic fascia was 68.3% (84/123). Other findings among the patients from our test group included intratendinous ca lcification (two cases), the presence of perifascial fluid (one case), atro phic heel pads (one case), and the partial rupture of plantar fascia (one c ase). Conclusion: Increased thickness and hypoechoic plantar fascia are consisten t sonographic findings in patients exhibiting PF. These objective measureme nts can provide sufficient information for the physician to confirm an init ial diagnosis of PF and assess individual treatment regimens.