Plantar fascia softens with age and in plantar fasciitis

NewsBot · Mar 2, 2011

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Sonoelastography of the Plantar Fascia.
Wu CH, Chang KV, Mio S, Chen WS, Wang TG.
Radiology. 2011 Feb 25. [Epub ahead of print]

Purpose: To compare the stiffness of the plantar fascia by using sonoelastography in healthy subjects of different ages, as well as patients with plantar fasciitis.

Materials and Methods: The study protocol was approved by the Research Ethics Committee of the hospital, and all of the subjects gave their informed consent. Bilateral feet of 40 healthy subjects and 13 subjects with plantar fasciitis (fasciitis group) were examined by using color-coded sonoelastography. Healthy subjects were divided into younger (18-50 years) and older (> 50 years) groups. The color scheme was red (hard), green (medium stiffness), and blue (soft). The color histogram was subsequently analyzed. Each pixel of the image was separated into red, green, and blue components (color intensity range, 0-255). The color histogram then computed the mean intensity of each color component of the pixels within a standardized area. Mixed model for repeated measurements was used for comparison of the plantar fascia thickness and the intensity of the color components on sonoelastogram.

Results: Quantitative analysis of the color histogram revealed a significantly greater intensity of blue in older healthy subjects than in younger (94.5 ± 5.6 [± standard deviation] vs 90.0 ± 4.6, P = .002) subjects. The intensity of red and green was the same between younger and older healthy subjects (P = .68 and 0.12). The intensity of red was significantly greater in older healthy subjects than in the fasciitis group (147.8 ± 10.3 vs 133.7 ± 13.4, P < .001). The intensity of green and blue was the same between older healthy subjects and those in the fasciitis group (P = .33 and .71).

Conclusion: Sonoelastography revealed that the plantar fascia softens with age and in subjects with plantar fasciitis
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mike weber · Mar 3, 2011

Maybe I´m having a sit in the back row in class moment.

Does someone want to explain this to me.

we have
red - high stiffness

green - medium stiffness

Blue reduced/less stiffness

or red reduced elasticity

green normal elasticity

blue increased elasticity

Now people with plantar fascia related problems get symptoms from increased tension within the plantar fascia- research has shown that the fascia will become thickened and less elastic .

But this research is saying as far as I can workout that the Fascia in those with symptoms is softer which I read as less stiff or more elastic .

Somebody help me out I don´t get it.

Kevin Kirby · Mar 3, 2011

m weber said: ↑

Maybe I´m having a sit in the back row in class moment.

Does someone want to explain this to me.

we have
red - high stiffness

green - medium stiffness

Blue reduced/less stiffness

or red reduced elasticity

green normal elasticity

blue increased elasticity

Now people with plantar fascia related problems get symptoms from increased tension within the plantar fascia- research has shown that the fascia will become thickened and less elastic .

But this research is saying as far as I can workout that the Fascia in those with symptoms is softer which I read as less stiff or more elastic .

Somebody help me out I don´t get it.
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Mike:

This one doesn't make sense to me either....something isn't right here. It would be interesting to read the full paper and see how accurate ultrasound is at determining the tensile force within the plantar fascia during weightbearing activities.

mike weber · Mar 3, 2011

Kevin Kirby said: ↑

Mike:

This one doesn't make sense to me either....something isn't right here. It would be interesting to read the full paper and see how accurate ultrasound is at determining the tensile force within the plantar fascia during weightbearing activities.
Click to expand...

I keep reading the abstract thinking no don´t get it.

Anyone have a full text copy ?

Kevin Kirby · Mar 3, 2011

Here is an article on the technology....don't know how accurate it is yet.

http://beaconpr.com/pdfs/Hospital.pdf

Kevin Kirby · Mar 3, 2011

This experimental study does make sense to me.

Clin Exp Rheumatol. 2010 May-Jun;28(3):373-8. Epub 2010 Jun 23.

Sonoelastography in the evaluation of painful Achilles tendon in amateur athletes.
Sconfienza LM, Silvestri E, Cimmino MA.

Unità di Radiologia, IRCCS Policlinico San Donato, San Donato Milanese, Italy.

Abstract
OBJECTIVES: The purpose of our paper was to evaluate by sonoelastography the Achilles tendon of asymptomatic volunteers and of patients referring for chronic overuse-associated pain, also comparing these findings with those obtained with B-mode ultrasound (US).

METHODS: This study had local Ethics Committee approval; all patients gave their written informed consent. Twelve patients (9 men, 3 women, median age 52.5 years, range 38-64 years) referred for unilateral Achilles tendon pain associated with amateur sporting activities and 18 healthy controls (11 men, 7 women, median age 54 years, range 27-64 years) were studied. US/sonoelastography were performed with a Logos EUB8500 system (Hitachi Ltd., Tokyo, Japan) equipped with a 10-6 MHz high-resolution broadband linear array, on 12 symptomatic tendons and 36 controls. The probe was positioned at the calcaneal enthesis, retrocalcaneal bursa, myotendineus juction, and in three different areas of the tendon body. The elastogram colour range was translated to a numeric score and the differences of tendon resilience were compared by the Kruskall-Wallis test.

RESULTS: On US, symptomatic tendons showed increased tendon thickness (12/12 tendons vs. 8/36 controls, p<0.0001), interruption (5/12 vs. 0/36, p=0.0004), and fragmentation (5/12 vs. 0/36, p=0.0004). Disappearance of fibrillar echotexture was comparable in the two groups. Symptomatic tendons were harder, showing a prevalence of blue to green colour (p<0.0001). Loss of elasticity was associated with both fragmentation (p=0.0089) and loss of fibrillar texture (p=0.0019), and was inversely correlated with tendon thickness (p<0.0001). Sonoelastography showed no difference between symptomatic and control tendons at the enthesis and myotendineus junction.

CONCLUSIONS: Sonoelastography shows increased stiffness in symptomatic enlarged Achilles tendons in comparison to normal ones.
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mike weber · Mar 3, 2011

That's what you would expect I agree increased stiffness in the symptomatic patients.

Tis a tangled web or the above study newsbot posted made a mess of things.

Kevin Kirby · Mar 3, 2011

Here's a good article from the Journal of Biomechanics on this technology:

http://silver.neep.wisc.edu/~lakes/TendonJBiomSD.pdf

NewsBot · Feb 15, 2014

Gender-Related Effect of Aging on the Sonographic Appearance of Plantar Fascia
Ju-Wen Cheng, Wen-Chung Tsai, and Tung-Yang, Yu
Journal of Musculoskeletal Pain

Objectives: To investigate the association between demographic variables [especially age] and the sonographic appearance of the plantar fascia [PF].

Methods: Twenty-six healthy volunteers [52 feet, age 24–79 years] without inferior heel pain were recruited. The thickness of the PF of the participants was measured in sonographic examination. The mean grey level in the region of interest in the sonogram of each PF was calculated using image processing software. Pearson’s correlation and stepwise regression analyses were performed between demographic variables and sonographic measures.

Results: The mean thickness of the PF was 0.319 ± 0.059 cm for men and 0.309 ± 0.093 cm for women. Stepwise regression analysis showed that age is an independent predictor of the thickness of the PF, and age and gender are independent predictors of echogenicity of the PF. Pearson’s correlation analysis showed significant positive correlations between age and thickness of the PF [r = 0.538] and between gender [male/female = 0/1] and echogenicity of the PF [r = 0.437]. A negative correlation between age and echogenicity of the PF [r = −0.344] was also shown. We divided the subjects into two gender-based groups and found significant correlations between age and sonographic measures only in the female group.

Conclusions: The thickness of the PF increases and the echogenicity of the PF decreases with age. Although the echogenicity of the PF is higher in women than in men, the PF of women shows a greater association with aging.
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