Osborne H R, Breidahl W H, Allison G T
Centre for Musculoskeletal Studies, School of Surgery and Pathology, The University of Western Australia, and Royal Perth Hospital, WA, Australia.
J Sci Med Sport. 2006 Jun;9(3):231-7. doi: 10.1016/j.jsams.2006.03.028. Epub 2006 May 11.
Plantar fasciitis is a clinical diagnosis and is often combined with some form of imaging to validate the diagnosis. The clinical utility of lateral X-rays lies in the fact that they are relatively inexpensive and may contribute to ruling out other osseous causes of pain. In this study 106 (27 plantar fasciitis (PF) and 79 controls) plain non-weight bearing lateral X-rays were examined by a blind examiner to document the key features of the lateral X-ray between images of individuals with and without plantar fasciitis. As expected calcaneal spurs were observed in both groups (85% PF and 46% controls). However, plantar fascia thickness and fat pad abnormalities resulted in the best group differentiation (p<0.0001) with sensitivity of 85% and specificity of 95% for plantar fasciitis. It was concluded that the key radiological features that differentiate the groups were not spurs but rather changes in the soft tissues. If it is deemed necessary to confirm the diagnosis of typical plantar fasciitis with imaging, a lateral non-weight bearing X-ray should be the first choice investigation especially if these key features are noted.
足底筋膜炎是一种临床诊断，通常结合某种形式的影像学检查来验证诊断。外侧X线片的临床价值在于其相对便宜，且有助于排除其他引起疼痛的骨源性病因。在本研究中，一名不知情的检查者对106张（27例足底筋膜炎（PF）患者和79例对照者）非负重位的普通外侧X线片进行了检查，以记录有或无足底筋膜炎个体的X线片关键特征。不出所料，两组均观察到跟骨骨刺（85%的PF患者和46%的对照者）。然而，足底筋膜厚度和脂肪垫异常在两组间差异最为显著（p<0.0001），对足底筋膜炎的敏感性为85%，特异性为95%。研究得出结论，区分两组的关键影像学特征不是骨刺，而是软组织的变化。如果认为有必要通过影像学检查来确诊典型的足底筋膜炎，尤其是在发现这些关键特征时，非负重位外侧X线片应作为首选检查。
