Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Chiayi, Taiwan.
Am J Phys Med Rehabil. 2013 Jul;92(7):597-605. doi: 10.1097/PHM.0b013e318278a831.
The aim of this study was to investigate the effectiveness of device-assisted ultrasound-guided steroid injection for treating plantar fasciitis.
An ultrasound-guided injection device designed with space for securing a transducer and syringe was used to guide steroid injection. Patients with unilateral plantar fasciitis were enrolled and randomly divided into device-assisted ultrasound-guided and palpation-guided groups. Pain intensity was measured using a visual analog scale and tenderness threshold. Ultrasound and pain intensity evaluations were performed before injection and at 3 wks and at 3 mos postinjection. Betamethasone (7 mg) and 1% lidocaine (0.5 ml) were injected into the inflamed plantar fascia.
Thirty-three patients who received either device-assisted ultrasound-guided or palpation-guided injection had significantly lower visual analog scale scores (P < 0.001) and higher tenderness threshold (P < 0.01) postinjection. However, the device-assisted group had higher tenderness threshold (9.02 ± 1.38 vs. 7.18 ± 2.11 kg/cm; P = 0.007), lower visual analog scale score (1.88 ± 2.13 vs. 3.63 ± 2.60; P = 0.046), and lower hypoechogenicity incidence in the plantar fascia (3/16 vs. 9/16; P = 0.033) than the palpation-guided group did at 3 mos postinjection. The heel pad was significantly thin (P = 0.004) in the palpation-guided group postinjection.
Device-assisted ultrasound-guided injection for treating plantar fasciitis results in better therapeutic outcomes than palpation-guided injection does.
本研究旨在探讨超声引导下器械注射治疗足底筋膜炎的效果。
使用一种带有固定换能器和注射器空间的超声引导注射装置来引导皮质类固醇注射。招募单侧足底筋膜炎患者，并随机分为器械辅助超声引导组和触诊引导组。使用视觉模拟量表和压痛阈值测量疼痛强度。在注射前、注射后 3 周和 3 个月时进行超声和疼痛强度评估。将倍他米松（7mg）和 1%利多卡因（0.5ml）注射到炎症性足底筋膜中。
接受器械辅助超声引导或触诊引导注射的 33 例患者的视觉模拟量表评分（P<0.001）和压痛阈值（P<0.01）均显著降低。然而，器械辅助组的压痛阈值（9.02±1.38 对 7.18±2.11kg/cm；P=0.007）更高，视觉模拟量表评分（1.88±2.13 对 3.63±2.60；P=0.046）更低，以及足底筋膜的低回声发生率（3/16 对 9/16；P=0.033）更低，在 3 个月时。触诊引导组的足跟垫在注射后明显变薄（P=0.004）。
与触诊引导注射相比，超声引导下器械注射治疗足底筋膜炎的疗效更好。
