Department of Orthopedic Surgery, Institute of Sports Medicine Copenhagen, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark.
Furesø-reumatologerne, Farum, Denmark.
Scand J Med Sci Sports. 2022 Nov;32(11):1660-1667. doi: 10.1111/sms.14221. Epub 2022 Aug 9.
Plantar fasciitis (PF) is a common disorder without objective parameters for disease severity.
To investigate whether structural changes in the plantar fascia and heel fat pad determined by ultrasound scanning with or without contrast are related to outcome measures in patients with symptomatic PF and to investigate whether there is an association between changes in US findings and improvement in pain and function.
All patients (n = 90) in a randomized controlled trial treated with training and/or glucocorticosteroid injection were assessed for morning pain, function pain, Foot Function Index (FFI), and ultrasound measured thickness of the fascia and heel fat pad at entry and after 6 months. Thirty patients were included in a longitudinal study that assessed pain, function, and microvascular volume (MV) by contrast-enhanced ultrasound at entry and after 5 months of treatment.
None of the ultrasound parameters at the initial examination were related to clinical outcomes at 5-6 months. Changes in US measured thickness of the fascia but not the fat pad correlated with improvement in all outcome measures at 6 months (FFI: r = 0.30, p = 0.005, morning pain: r = 0.21, p = 0.046, function pain: r = 0.28, p = 0.007). MV did not change despite significant improvement in symptoms.
Changes in ultrasound measured fascia thickness are associated with clinical improvement in PF patients.
足底筋膜炎（PF）是一种常见疾病，没有用于疾病严重程度的客观参数。
研究超声扫描（有无对比剂）确定的足底筋膜和跟骨脂肪垫的结构变化是否与症状性 PF 患者的结局测量值相关，并研究 US 发现的变化与疼痛和功能改善之间是否存在关联。
在一项随机对照试验中，所有接受训练和/或糖皮质激素注射治疗的患者（n=90）在入组时和 6 个月后评估早晨疼痛、功能疼痛、足部功能指数（FFI）以及超声测量的筋膜和跟骨脂肪垫厚度。30 名患者纳入一项纵向研究，该研究在入组时和治疗 5 个月后通过对比增强超声评估疼痛、功能和微血管容积（MV）。
初始检查时的任何超声参数均与 5-6 个月时的临床结果无关。US 测量的筋膜厚度变化，但不是脂肪垫厚度变化与 6 个月时所有结局测量值的改善相关（FFI：r=0.30，p=0.005；早晨疼痛：r=0.21，p=0.046；功能疼痛：r=0.28，p=0.007）。尽管症状明显改善，但 MV 并未改变。
超声测量的筋膜厚度变化与 PF 患者的临床改善相关。
