Tseng Wen-Che, Chen Yun-Chang, Lee Tsung-Min, Chen Wen-Shiang
Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan.
Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
J Med Ultrasound. 2023 Oct 6;31(4):268-274. doi: 10.4103/jmu.jmu_2_23. eCollection 2023 Oct-Dec.
Plantar fasciitis (PF) is a common musculoskeletal disease. Histologic findings of patients with PF showed mainly chronic degenerative processes rather than inflammation. In addition to mechanical factors, such as repetitive stress and reduced ankle dorsiflexion, PF is also linked to rheumatologic diseases and genetic factors. Ultrasound is becoming a standard imaging technique for assessing PF. Major sonographic findings included increased plantar fascia thickness and hypoechoic plantar fascia. In addition to traditional B-mode ultrasound, sonoelastography can also be utilized to diagnose PF. Ultrasound can also be used to guide therapeutic interventions. Over 80% of patients with PF improved under nonsurgical treatment. Treatment options for PF include physical therapy, modalities (laser, therapeutic ultrasound), extracorporeal shock wave therapy (ESWT), injections, transcatheter arterial embolization, and surgery. For injections, corticosteroid was mostly used in the past but has been replaced gradually by other techniques such as platelet-rich plasma or dextrose prolotherapy. There is also more and more evidence about ESWT in treating PF. Surgery serves as an option for recalcitrant PF cases, and endoscopic fasciotomy seemed to have good outcomes. Ultrasound plays an important role in diagnosing of PF and evaluating the treatment effect, and the use of sonoelastography in addition to traditional B-mode ultrasound may help in the early detection of PF and assessment of the treatment effect.
足底筋膜炎（PF）是一种常见的肌肉骨骼疾病。PF患者的组织学表现主要为慢性退行性变，而非炎症。除了重复性应力和踝关节背屈减少等机械因素外，PF还与风湿性疾病和遗传因素有关。超声正成为评估PF的标准成像技术。主要超声表现包括足底筋膜增厚和足底筋膜低回声。除传统B超外，超声弹性成像也可用于诊断PF。超声还可用于指导治疗干预。超过80%的PF患者在非手术治疗下病情改善。PF的治疗选择包括物理治疗、物理治疗手段（激光、治疗性超声）、体外冲击波疗法（ESWT）、注射、经导管动脉栓塞术和手术。过去注射大多使用皮质类固醇，但已逐渐被其他技术如富血小板血浆或葡萄糖增殖疗法所取代。关于ESWT治疗PF的证据也越来越多。手术是顽固性PF病例的一种选择，内镜下筋膜切开术似乎效果良好。超声在PF的诊断和治疗效果评估中起着重要作用，除传统B超外，超声弹性成像的应用可能有助于PF的早期检测和治疗效果评估。
