Yi Tae Im, Lee Ga Eun, Seo In Seok, Huh Won Seok, Yoon Tae Hee, Kim Bo Ra
Department of Rehabilitation Medicine, Bundang Jesaeng General Hospital, Seongnam 463-774, Korea.
Ann Rehabil Med. 2011 Aug;35(4):507-13. doi: 10.5535/arm.2011.35.4.507. Epub 2011 Aug 31.
The objectives of this study were to investigate the causes of plantar heel pain and find differences in the clinical features of plantar fasciitis (PF) and fat pad atrophy (FPA), which are common causes of plantar heel pain, for use in differential diagnosis.
This retrospective study analyzed the medical records of 250 patients with plantar heel pain at the Foot Clinic of Rehabilitation Medicine at Bundang Jesaeng General Hospital from January to September, 2008.
The subjects used in this study were 114 men and 136 women patients with a mean age of 43.8 years and mean heel pain duration of 13.3 months. Causes of plantar heel pain were PF (53.2%), FPA (14.8%), pes cavus (10.4%), PF with FPA (9.2%), pes planus (4.8%), plantar fibromatosis (4.4%), plantar fascia rupture (1.6%), neuropathy (0.8%), and small shoe syndrome (0.8%). PF and FPA were most frequently diagnosed. First-step pain in the morning, and tenderness on medial calcaneal tuberosity correlated with PF. FPA mainly involved bilateral pain, pain at night, and pain that was aggravated by standing. Heel cord tightness was the most common biomechanical abnormality of the foot. Heel spur was frequently seen in X-rays of patients with PF.
Plantar heel pain can be provoked by PF, FPA, and other causes. Patients with PF or FPA typically show different characteristics in clinical features. Plantar heel pain requires differential diagnosis for appropriate treatment.
本研究的目的是调查足跟底部疼痛的原因，并找出足底筋膜炎（PF）和脂肪垫萎缩（FPA）这两种足跟底部疼痛常见原因在临床特征上的差异，以用于鉴别诊断。
这项回顾性研究分析了2008年1月至9月盆唐耶稣总医院康复医学足部诊所250例足跟底部疼痛患者的病历。
本研究的受试者为114例男性和136例女性患者，平均年龄43.8岁，足跟疼痛平均持续时间13.3个月。足跟底部疼痛的原因包括PF（53.2%）、FPA（14.8%）、高弓足（10.4%）、PF合并FPA（9.2%）、扁平足（4.8%）、足底纤维瘤病（4.4%）、足底筋膜破裂（1.6%）、神经病变（0.8%）和小鞋综合征（0.8%）。PF和FPA是最常被诊断出的病因。早晨第一步疼痛以及跟骨内侧结节压痛与PF相关。FPA主要表现为双侧疼痛、夜间疼痛以及站立时疼痛加重。跟腱紧张是足部最常见的生物力学异常。PF患者的X线检查中经常可见足跟骨刺。
足跟底部疼痛可由PF、FPA和其他原因引起。PF或FPA患者在临床特征上通常表现出不同特点。足跟底部疼痛需要进行鉴别诊断以进行恰当治疗。
