Magnetic resonance imaging findings of chronic plantar fasciitis before and after extracorporeal shock wave therapy. (December 2017)

• Record Type: Journal Article
• Authors: Maki, Masahiro; Ikoma, Kazuya; Kido, Masamitsu; Hara, Yusuke; Sawada, Koshiro; Ohashi, Suzuyo; Kubo, Toshikazu
• Is Part Of: Foot. Volume 33(2017)
• Page Start: 25
• Page End: 28
• Publication Date: 2017-12
• Subjects: Chronic plantar fasciitis -- Extracorporeal shock wave therapy -- Magnetic resonance imaging; Foot -- Diseases -- Periodicals; Foot -- Surgery -- Periodicals; Foot Diseases -- Periodicals; Foot -- surgery -- Periodicals; Pied -- Maladies -- Périodiques; Pied -- Chirurgie -- Périodiques; Pied -- Lésions et blessures -- Périodiques; Foot -- Diseases; Foot -- Surgery; Periodicals; Electronic journals; Electronic journals; 617.585005
• DOI: 10.1016/j.foot.2017.10.002
• Languages: English
• ISSNs: 0958-2592

Abstract

Highlights: The inflammation surrounding the PF is improved by the stimulation of soft tissue healing by removal of inflammatory debris and promotion of neovascularization in ESWT. These two point may have contributed most to the improvement in clinical symptoms. Abstract: Introduction: The objective of this study is to examine the relationships between treatment outcome and changes in magnetic resonance (MR) imaging findings after extracorporeal shock wave therapy (ESWT) for chronic plantar fasciitis. Methods: The subjects were 23 feet of 23 patients of refractory plantar fasciitis. The mean age was 53.7 years. The thickness of the plantar fascia (PF) and findings of a high-signal intensity area (HSIA) inside the PF, edema around the PF, and bone marrow edema (BME) of the calcaneus were investigated on MR images. The Japanese Society for Surgery of the Foot (JSSF) ankle-hindfoot scale and a visual analogue scale (VAS) were used. Correlations between an improvement in symptoms and one in the MRI findings were analyzed. Results: The mean thickness of the PF was 4.4 ± 1.6 mm before ESWT and 4.6 ± 1.8 mm six months after ESWT. After ESWT, there was a decrease in the numbers of feet showing HSIA inside the PF from 15 to 6, in edema around the PF from 16 to 2, and in BME of the calcaneus from 11 to 4. Clinical outcomes improved with ESWT from 70.3 ± 5.5 to 88.6 ± 9.1 points (JSSF), 74.1 ± 25.3 to 28.5 ± 24.4 points (VAS), respectively. Improvements in symptoms according to the JSSF and VAS scores and improvement in edema around the PF on MR images showed a significant correlation. Conclusions: Edema around the PF improved significantly in association with an improvement in symptoms after ESWT.