Additional diagnostic value of digital radiology in plantar fasciitis diagnosis
Abstract: Ultrasonography
(USG) is regarded as the gold standard to differentiate normal plantar fascia
and plantar fasciitis. Conventional radiography or plain X-ray is typically
used to exclude differential diagnosis. Lately, conventional radiography has
been digitalized and leads to better visualization of the soft tissue. However,
it is not known whether digital radiography evaluation for calcaneus area, both
qualitative and quantitative, has a similar diagnostic value as USG findings.
Therefore, this study aimed to evaluate whether there is a strong correlation
between digital radiographic and USG findings for diagnosing plantar fasciitis.
Methods: This is a cross sectional study examining adult patients (>18
years old) presenting with inferior heel pain. Plantar aponeurosis thickness
was measured by digital radiography and ultrasonography; measurement was
performed three times in each modality, and the average value was recorded. Fat
stranding, presence of calcaneal enthesophyte, and microfracture were also
evaluated in digital radiography. Measurement results were classified into
plantar fasciitis diagnosis using the cut-off value 4 mm.
Results: There was no significant correlation between plantar aponeurosis
thickness measured by digital radiography and by ultrasonography (r=0.069,
p=0.688). There was no significant association between plantar fasciitis
diagnosis by digital radiography and ultrasonography (p=0.162). However,
digital radiography showed good sensitivity to detect plantar fasciitis using a
cut-off value of >4 mm plantar fascia thickness.
Conclusion: Digital radiography might be used to aid definitive diagnosis
for plantar fasciitis.
Keywords: calcaneus bone;
digital radiography; plantar fasciitis; plantar aponeurosis; ultrasonography
Author: Marcel Prasetyo,
Thariqah Salamah, Trifonia P. Siregar
Journal Code: jpkedokterangg170199
