Reproducibility of sonographic measurement of thickness and echogenicity of the plantar fascia
Two articles on PainSci cite Cheng 2012: 1. Complete Guide to Plantar Fasciitis
PainSci commentary on Cheng 2012: ?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.
Based on 56 feet, 20 with inferior heel pain, researchers concluded that “the reliability of sonographic examination of the thickness of the plantar fascia is high,” with no advantage to a transverse scan.
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
BACKGROUND: To evaluate the intra- and interrater reliability of ultrasonographic measurements of the thickness and echogenicity of the plantar fascia.
METHODS: Eleven patients (20 feet), who complained of inferior heel pain, and 26 volunteers (52 feet) were enrolled. Two sonographers independently imaged the plantar fascia in both longitudinal and transverse planes. Volunteers were assessed twice to evaluate intrarater reliability. Quantitative evaluation of the echogenicity of the plantar fascia was performed by measuring the mean gray level of the region of interest using Digital Imaging and Communications in Medicine viewer software.
RESULTS: Sonographic evaluation of the thickness of the plantar fascia showed high reliability. Sonographic evaluations of the presence or absence of hypoechoic change in the plantar fascia showed surprisingly low agreement. The reliability of gray-scale evaluations appears to be much better than subjective judgments in the evaluation of echogenicity. Transverse scanning did not show any advantage in sonographic evaluation of the plantar fascia.
CONCLUSIONS: The reliability of sonographic examination of the thickness of the plantar fascia is high. Mean gray-level analysis of quantitative sonography can be used for the evaluation of echogenicity, which could reduce discrepancies in the interpretation of echogenicity by different sonographers. Longitudinal instead of transverse scanning is recommended for imaging the plantar fascia.
related content
- “Application of ultrasound in the assessment of plantar fascia in patients with plantar fasciitis: a systematic review,” Mohseni-Bandpei et al, Ultrasound in Medicine & Biology, 2014.
- “The correlation between plantar fascia thickness and symptoms of plantar fasciitis,” Mahowald et al, Journal of the American Podiatric Medical Association, 2011.
- “Ultrasonographic evaluation in plantar fasciitis,” Karabay et al, Journal of Foot & Ankle Surgery, 2007.
- “The relationship between the flexible flatfoot and plantar fasciitis: ultrasonographic evaluation,” Huang et al, Chang Gung J Med, 2004.
- “Interrater reliability: the kappa statistic,” McHugh, Biochem Med (Zagreb), 2012.
- “The measurement of observer agreement for categorical data,” Landis et al, Biometrics, 1977.
Specifically regarding Cheng 2012:
- Plantar Fasciitis Patients Have Thick Soles — There’s a connection between plantar fasciitis and a surprisingly thick tissue in the arch of the foot
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- Cannabidiol (CBD) products for pain: ineffective, expensive, and with potential harms. Moore 2023 J Pain.
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- Prediction of an extruded fragment in lumbar disc patients from clinical presentations. Pople 1994 Spine (Phila Pa 1976).
- Characteristics of patients with low back and leg pain seeking treatment in primary care: baseline results from the ATLAS cohort study. Konstantinou 2015 BMC Musculoskelet Disord.
- Effectiveness and cost-effectiveness of universal school-based mindfulness training compared with normal school provision in reducing risk of mental health problems and promoting well-being in adolescence: the MYRIAD cluster randomised controlled trial. Kuyken 2022 Evid Based Ment Health.