Title: Evaluation of the Diagnostic Role of Ultrasonography Compared to Magnetic Resonance Imaging in Plantar Fasciitis
Authors: Mai Darwish, Mohammed E. Eid, Tamer Y. Gaweesh, Abdelaziz El Nekeidy
DOI: https://dx.doi.org/10.18535/jmscr/v7i6.95
Abstract
Objective: The aim of the study was to assess the role of ultrasonography in the diagnosis of plantar fasciitis in comparison to the diagnostic magnetic resonance imaging (MRI) in patients with chronic heel pain.
Methods: This study was conducted on 21 patients clinically diagnosed as plantar fasciitis from November 2013 till February 2015. Five age- and sex-matched asymptomatic volunteers served as a control group. Patients were examined by sagittal ultrasonography and conventional MRI (T1WI, T2WI and PDW-SPAIR sequences). MRI was considered the gold standard for diagnosis. And the sonographic appearances of the plantar fascia were compared with MRI findings. Plantar fascia thickness was also measured by both imaging modalities.
Results: The plantar fascia was thicker in symptomatic feet (2.50 – 9.30 mm; 6.00± 1.54) than in the control group (1.70 – 3.80 mm; 3.08± 0.91) as measured by ultrasound. Other sonographic signs used for the diagnosis of plantar fasciitis in the study were compared to MRI findings. The diagnostic accuracy was 85.71% for abnormal focal thickening and abnormal echogenicity within the plantar fascia, 76.19 % for soft tissue edema and the lowest diagnostic accuracy of ultrasound was in the detection of associated calcaneal spur (38.10%). Compared with MRI, ultrasonography showed 89.47 %% sensitivity and 50% specificity in assessing plantar fasciitis, with overall diagnostic performance of 85.71%.These findings were tabulated and discussed in relation to other literature.
Conclusion: Although MRI is the modality of choice in the diagnosis of plantar fasciitis, diagnostic accuracy of ultrasound is comparable to that of MRI and it could be the initial imaging modality to confirm clinically suspected plantar fasciitis. MRI may be reserved for equivocal cases, symptomatic cases with negative ultrasound results and when complex pathology is suspected.
Keywords: MRI, plantar fasciitis, ultrasound.
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