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Sonographically Guided Corticosteroid Injection for Treatment of Plantar Fasciosis
Author(s) -
Kayhan Arda,
Gökay Nevzat Selim,
Alpaslan Rümeysa,
Demirok Mehmet,
Yılmaz İbrahim,
Gökçe Alper
Publication year - 2011
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/jum.2011.30.4.509
Subject(s) - medicine , corticosteroid , surgery
Objectives The purpose of this study was to prospectively investigate the effect of sonographically guided corticosteroid injection on the clinical and radiologic responses in patients with proximal plantar fasciosis. Methods Thirty‐one consecutive patients with unilateral plantar fasciosis were enrolled. A 4‐cm 21‐gauge needle was positioned in a caudocranial oblique manner, and the needle was withdrawn to the near edge of the fascia so that the solution dispersed around the edge. Two milliliters (20 mg/mL) of lignocaine/prilocaine, 1%, and 0.5 mL (20 mg) of methylprednisolone acetate solutions were injected separately. The plantar fascia and fat pad thickness, fascial echogenicity, and perifascial edema were assessed with a 10–5 MHz linear array transducer. The American Orthopedic Foot and Ankle Society midfoot scale was used to assess function, alignment, and pain. The initial radiologic and clinical measurements were compared with data obtained not less than 6 weeks after the injections. Results A statistically significant decrease in the mean plantar fascia thickness was detected after treatment ( P < .0001). There was no statistically significant difference in the plantar fascia echogenicity before and after treatment ( P = .11). A statistically significant decrease was found for perifascial edema ( P < .0001), and a statistically significant increase in American Orthopedic Foot and Ankle Society scores was detected ( P = .0007). There was no decrease in fat pad thickness ( P > .1). Plantar fascia rupture was detected in 1 patient. Conclusions Sonographically guided corticosteroid injection enables real‐time imaging of the plantar fascia during needle insertion. A caudocranial oblique injection beneath the fascia may have an incremental value in the treatment response in patients with plantar fasciosis.