Alviti Federica, D'Ercole Chiara, Schillizzi Giuseppe, Mangone Massimiliano, Bernetti Andrea, Ioppolo Francesco, Di Sante Luca, Minafra Paolo, Santilli Valter, Elia Daniela, Vallone Gianfranco, D'ambrosio Ferdinando, Cantisani Vito
Department of Anatomy, Histology, Forensic Medicine and Orthopedics, Board of Physical Medicine and Rehabilitation, "Sapienza" University, Rome, Italy.
Department of Radiology, "Sapienza", University of Rome, Italy.
Med Ultrason. 2019 Nov 24;21(4):399-404. doi: 10.11152/mu-1976.
To assess the ultrasound features in patients with plantar fasciopathy before and after extracorporeal shock waves therapy (ESWT), using conventional grey-scale imaging and both strain (SE) and shear wave (SWE) elastosonographic evaluation.
Consecutive patients of both sexes attending our outpatient's clinic, with diagnosis of unilateral plantar fasciopathy, were enrolled. Patients were treated with 3 sessions of ESWT once a week, and underwent clinical and ultrasound evaluation at baseline and at one and three months after treatment. Roles and Maudsley score (RM), visual analog scale (VAS) and 17-Italian Foot Function Index (FFI), were used to assess pain and functional improvement.
Twenty patients (11 female and 9 male) were enrolled in the study. Contralateral asymptomatic healthy plantar fascia was used as a control. At baseline, SWE velocity (SWEv) showed statistically significant difference between affected 3.8 (1.5; 5.1) m/s and healthy side 4.7 (4.07; 7.04) m/s, (p=0.006); no significant difference was found for strain ratio values (p=0.656). SWEv post hoc test results showed a significant difference from baseline 3.8 (1.5-5.1) m/s and three month 5.23 (4.55-6.74) m/s follow up visit (p=0.003). Significant statistical negative correlation was found between the SWEv and VAS (p=0.001) and positive correlation between the SWEv and FFI (p=0.012).
SWE was effective in assessing plantar fascia elasticity and its alteration in fasciopathy. Furthermore, on the basis of the correlation with pain and functional scales, this technique appears to be a useful additional technique to conventional ultrasound for monitoring the efficacy of treatment.
采用传统灰阶成像以及应变（SE）和剪切波（SWE）弹性超声评估，来评估体外冲击波疗法（ESWT）前后足底筋膜炎患者的超声特征。
纳入在我院门诊就诊、诊断为单侧足底筋膜炎的连续患者，男女不限。患者接受每周1次、共3次的ESWT治疗，并在基线、治疗后1个月和3个月接受临床和超声评估。采用罗尔斯和莫兹利评分（RM）、视觉模拟量表（VAS）和17项意大利足功能指数（FFI）来评估疼痛和功能改善情况。
20例患者（11例女性和9例男性）纳入研究。对侧无症状健康足底筋膜用作对照。基线时，患侧的SWE速度（SWEv）为3.8（1.5；5.1）m/s，健侧为4.7（4.07；7.04）m/s，差异有统计学意义（p = 0.006）；应变比值无显著差异（p = 0.656）。SWEv的事后检验结果显示，与基线3.8（1.5 - 5.1）m/s和3个月随访时的5.23（4.55 - 6.74）m/s相比有显著差异（p = 0.003）。SWEv与VAS之间存在显著的统计学负相关（p = 0.001），与FFI之间存在正相关（p = 0.012）。
SWE可有效评估足底筋膜弹性及其在筋膜炎中的变化。此外，基于与疼痛和功能量表的相关性，该技术似乎是传统超声用于监测治疗效果的一种有用的辅助技术。
