Daskareh Mahyar, Mehdipour Dalivand Mahsa, Esmaeilian Saeid, Pourrajabi Aseme, Moshtaghioon Seyed Ali, Rahmanipour Elham, Jamshidi Ahmadreza, Alikhani Majid, Ghorbani Mohammad
Department of Radiology, University of California San Diego, San Diego, CA 92093, USA.
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.
Diagnostics (Basel). 2025 Aug 5;15(15):1967. doi: 10.3390/diagnostics15151967.
Plantar fasciitis (PF) is a common enthesopathy in patients with ankylosing spondylitis (AS). Shear wave elastography (SWE) and the Belgrade ultrasound enthesitis score (BUSES) may detect PF, but their comparative diagnostic performance is unclear. To compare SWE with the BUSES for identifying PF in individuals with and without AS. In this cross-sectional study, 96 participants were stratified into AS and non-AS populations, each further divided based on the presence or absence of clinical PF. Demographic data, the American Orthopedic Foot and Ankle Society Score (AOFAS), and the BASDAI score were recorded. All subjects underwent grayscale ultrasonography, the BUSES scoring, and SWE assessment of the plantar fascia. Logistic regression models were constructed for each population, controlling for age, body mass index (BMI), and fascia-skin distance. ROC curve analyses were performed to evaluate diagnostic accuracy. In both AS and non-AS groups, SWE and the BUSES were significant predictors of PF ( < 0.05). SWE demonstrated slightly higher diagnostic accuracy, with area under the curve (AUC) values of 0.845 (AS) and 0.837 (non-AS), compared to the BUSES with AUCs of 0.785 and 0.831, respectively. SWE also showed stronger adjusted odds ratios in regression models. The interobserver agreement was good to excellent for both modalities. Both SWE and the BUSES are effective for PF detection, with SWE offering marginally superior diagnostic performance, particularly in AS patients. SWE may enhance the early identification of biomechanical changes in the plantar fascia.
足底筋膜炎（PF）是强直性脊柱炎（AS）患者中常见的附着点病。剪切波弹性成像（SWE）和贝尔格莱德超声附着点炎评分（BUSES）可能检测出PF，但它们的比较诊断性能尚不清楚。为比较SWE和BUSES在有无AS个体中识别PF的情况。在这项横断面研究中，96名参与者被分为AS组和非AS组，每组再根据是否存在临床PF进一步划分。记录人口统计学数据、美国矫形足踝协会评分（AOFAS）和巴斯强直性脊柱炎疾病活动指数（BASDAI）评分。所有受试者均接受了足底筋膜的灰阶超声检查、BUSES评分和SWE评估。针对每组人群构建逻辑回归模型，控制年龄、体重指数（BMI）和筋膜-皮肤距离。进行ROC曲线分析以评估诊断准确性。在AS组和非AS组中，SWE和BUSES都是PF的显著预测指标（<0.05）。SWE显示出略高的诊断准确性，曲线下面积（AUC）值分别为0.845（AS组）和0.837（非AS组），而BUSES的AUC值分别为0.785和0.831。SWE在回归模型中也显示出更强的调整优势比。两种方法的观察者间一致性均为良好至优秀。SWE和BUSES对PF检测均有效，SWE的诊断性能略优，尤其是在AS患者中。SWE可能会增强对足底筋膜生物力学变化的早期识别。
