Hyperaemia in Plantar Fasciitis

NewsBot · Oct 16, 2013

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Hyperaemia in Plantar Fasciitis Determined by Power Doppler Ultrasound
Andrew M. McMillan, Karl B. Landorf, Julie M. Gregg, Jason De Luca, Matthew P. Cotchett, Hylton B. Menz
Journal of Orthopaedic & Sports Physical Therapy, 0, Volume: Early Access Issue: Early Access Pages: 1-21 doi:10.2519/jospt.2013.4810

Study Design Cross-sectional observational study.

Objective To investigate the presence of soft tissue hyperaemia in plantar fasciitis with power Doppler ultrasound.

Background Localised hyperaemia is an established feature of tendinopathies, suggesting that neurovascular in-growth may contribute to tendon associated pain for some patients. The presence of abnormal soft tissue vascularity can be assessed with Doppler ultrasound, and a positive finding can assist with targeted treatment plans. However, very little is known regarding the presence of hyperaemia in plantar fasciitis, and the ability of routine Doppler ultrasound to identify vascular in-growth in the plantar fascia near its proximal insertion.

Methods This observational study included 30 participants with plantar fasciitis unrelated to systemic disease and 30 age- and sex-matched controls. Ultrasound examination was performed with a 13-5 MHz linear transducer and power Doppler images were assessed by 2 blinded investigators.

Results Hyperaemia of the plantar fascia was present in 8 of 30 participants with plantar fasciitis, and 2 of 30 controls. The between-group difference for hyperaemia using a 4-point scale was statistically significant, with participants with plantar fasciitis showing increased Doppler ultrasound signal compared to controls (Mann-Whitney U, P = .03). However, the majority of participants with plantar fasciitis with evidence of hyperaemia demonstrated very mild color changes, and only 3 were found to have moderate or marked hyperaemia.

Conclusions Mild hyperaemia can occur with plantar fasciitis, but most individuals will not exhibit greater soft tissue vascularity when assessed with routine Doppler ultrasound. Clinicians treating plantar fasciitis should not consider a positive Doppler signal essential for diagnosis of the condition, but rather a feature that may refine the treatment plan for an individual patient.
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Admin2 · Oct 16, 2013

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