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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
Re: Plantar fascia softens with age and in plantar fasciitis
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 .
Re: Plantar fascia softens with age and in plantar fasciitis
Quote:
Originally Posted by m weber
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.
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.
__________________
Sincerely,
Kevin
**************************************************
Kevin A. Kirby, DPM
Adjunct Associate Professor
Department of Applied Biomechanics
California School of Podiatric Medicine at Samuel Merritt College
Re: Plantar fascia softens with age and in plantar fasciitis
Quote:
Originally Posted by Kevin Kirby
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.
I keep reading the abstract thinking no don´t get it.
**************************************************
Kevin A. Kirby, DPM
Adjunct Associate Professor
Department of Applied Biomechanics
California School of Podiatric Medicine at Samuel Merritt College
Re: Plantar fascia softens with age and in plantar fasciitis
This experimental study does make sense to me.
Quote:
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.
__________________
Sincerely,
Kevin
**************************************************
Kevin A. Kirby, DPM
Adjunct Associate Professor
Department of Applied Biomechanics
California School of Podiatric Medicine at Samuel Merritt College
Plantar fascia softens with age and in plantar fasciitis
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