Subcalcaneal Fat Pad Thickness and Plantar Heel Pain

NewsBot · Jan 28, 2019

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Relationship Between Decreased Subcalcaneal
Fat Pad Thickness and Plantar Heel Pain. A Case
Control Study
Daniel López-López et al
Pain Physician 2019: 22:109-116

Background: Heel pain is one of the most frequent complaints in medical clinical
practice for conditions affecting the feet during weight-bearing tasks.
Objective: The goal of this study was to measure and compare the thickness of the
fat pad in a sample of patients with current unilateral heel pain and patients without
unilateral heel pain with normalized reference parameters.
Study Design: This was an observational case-control study.
Settings: The research took place in the podiatry department within a medical health
care center.
Methods: A total of 375 patients were randomly selected from a pool of patients
attending a medical health care center between the years 2008 and 2015 and diagnosed
by a single medical podiatrist without having previous treatment. Patients were categorized
in 2 groups: a heel pain group (n = 185) and a control group (asymptomatic; n = 190). The
thickness of the plantar fat pad was measured with an ultrasonic probe (BodyMetrix® BX
2000; IntelaMetrix, Inc, Livermore, CA).
Results: Initial examination of both groups indicated no significant differences in age,
height, weight, or body mass index (P > 0.01). There were, however, significant differences
in the thickness of the fat pad between those in the heel pain group and those in the control
group, when analyzed by group and by gender (P < 0.01; Cohen´s d = 0.465-1.959).
Limitations: The study was not a randomized controlled trial. Although primary
outcome data were self-reported, the assessor was not blinded.
Conclusion: This study provides further evidence that people with unilateral heel pain
showed a significantly decreased thickness of the subcalcaneal fat pad, regardless of
gender.
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NewsBot · Aug 25, 2019

The thickness of heel fat-pad in patients with plantar fasciitis.
Belhan O et al
Acta Orthop Traumatol Turc. 2019 Aug 20

OBJECTIVE:
The aim of this study was to investigate the thickness of heel fat pad (THP) and to detect the relationship between the plantar fasciitis (PF) and age, occupation, BMI, longitudinal arch, the thickness of heel fat-pad in the patients with PF.

METHODS:
A total of 50 patients (29 women and 21 men; mean age: 46.5 years (range: 22-70)) that were diagnosed with PF were included to this study. Patients' affected side were compared with the healthy opposite side with the angle of medial arch (AMA) and first metatarsophalangeal angle (FMTPA) on the foot radiograms, and THP and thickness of first metatarsal fat pad (TFMFP) using ultrasonography (USG) of both feet.

RESULTS:
The mean AMAs of feet with pain and without pain were 122.56° and 120.60°, respectively. The mean FMTPAs of feet with pain and without pain were 14.72° and 14.40°, respectively. The mean THPs of feet with pain at the point of the medial calcaneal tubercle and the mean TFMFPs of the feet with pain at the point of the first metatarsal head were 19.45 mm and 6.75 mm, respectively. The mean THPs of feet without pain at the point of the medial calcaneal tubercle and the mean TFMFPs of the feet without pain at the point of the first metatarsal head were 19.94 mm and 6.75 mm, respectively. It was observed that the mean AMA in the heels with pain was significantly higher than that of the heel without pain (p < 0.05) and the mean THP in the heels with pain was significantly thinner than that of the heel without pain (p < 0.05).

CONCLUSION:
The results indicate that USG is an accurate and reliable imaging technique for the measurement of THP in the diagnosis of plantar fasciitis and the heel pad was thinner in the painful heels of patients with plantar fasciitis.
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NewsBot · Dec 5, 2019

Clinico-radiological study of heel pain patients with
special reference to heel pad thickness: A hospital
based study
Dr. Barua DS and Dr. Bora D
International Journal of Orthopaedics Sciences 2019; 5(4): 557-560

Background: Heel pain debilitates the quality of life. Causes of this pain are many but exact diagnosis is
lacking in majority. Change of architecture and mechanical properties of plantar heel pad is considered a
major cause.
Materials and method: Prospective observational study with 194 cases of heel pain from 1st July 2006
to 1st November 2007. Acute heel pain following trauma, infection, tumour or other foot deformities were
excluded. Standardised questionnaire, clinical examination and standard lateral wt. bearing & non-wt.
bearing xrays view of foot projected at the calcaneum were taken to measure body weight loaded Heel
Pad Thickness (LHPT) & unloaded Heel Pad Thickness (UHPT). Heel Pad Compressibility Index was
measured by HPCI= (LHPT/UHPT).
Results: 194 cases with heel pain were included in the study. 88 cases are male, 72 cases are female
patients. (Ratio male: female = 1. 2: 1). Mean UHPT=20.7mm, LHPT=12.19mm, HPCI=0.58mm. HPCI
tends to increase with increase in age (> 40 yrs age group). No significant difference in UHPT, LHPT,
HPCI between males and female was noted.
Conclusion: This is probably the first study in the North Eastern Region of India, which evaluated heel
pain associated with heel pad thickness and compressibility index
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NewsBot · Jan 31, 2023

Relationship Between Subcalcaneal Fat Pad Thickness And
Plantar Heel Pain: A Case Control Study
BN Roshan Kumar et al
European Journal of Molecular & Clinical Medicine

Background: Heel pain is common in active young and old adults. Plantar pain usually
develops due to degeneration of heel fat pad. Loss of elasticity and changes in thickness of
fat pad are considered to cause plantar heel pain.
Objectives:
1. To compare sub calcaneal fat pad thickness and its compressibility between the patients
with and without current plantar heel pain.
2. To assess correlation of heel pad parameters with age and BMI.
Materials and Methods: A case control study was conducted in the Department of
orthopaedics at Raja Rajeswari Medical College and Hospital. Heel pad compressibility
index, heel pad thickness in loading (HPTL), heel pad thickness in unloading (HPTUL)
were considered as primary outcome variables and demographic variables, anthropometric
variables, were considered as Study relevant parameters. Heel Pain was considered as
Primary explanatory variable.
Results: There was significant difference in the median values of heel pad parameters
between cases and controls (HPCI:0.85 v/s 0.66, HPTL: 12.00 v/s 11.25, HPTUL:15.00 v/s
18.00, p<0.001). Among cases, age showed positive correlation with HPCI and HPTL with
a r value of 0.26, 0.18 respectively (p<0.0%). BMI showed positive correlation with
HPTUL with a r value of 0.22 (p<0.05). Heel pad parameters failed to show correlation
with age and BMI except that BMI showed negative correlation (r=-0.32, p<0.05) with
HPCI among controls.
Conclusion: The findings of the study showed difference in heel fat pad thickness and
elasticity between participants with and without heel pain. Age and body mass index
showed positive correlation with heel pad parameters which indicates that increase in
thickness of heel fat pad is one of the causes of heel pain.
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