Sonographic assessment of extrinsic foot muscles in patients with plantar fasciitis: A case-control study

Abdul Sattar Arif Khammas, Rozi Mahmud, Safwan Saeed Mohammed, Idris Ibrahim, Hasyma Abu Hassan

Abstract


Purpose: Plantar fasciitis (PFS) is the most common cause of plantar heel pain and is reported to affect 10% of the general population at any point in their lifetime. The objective of this study was to determine the differences of the thickness and cross-sectional area (CSA) of the tibialis anterior (TA), extensor digitorum longus (EDL), peroneus (PER) muscles and the PF thickness between individuals with plantar fasciitis (PFS) and healthy subjects. 

Materials and Methods: A total of 80 subjects were collected and divided into two groups: PFS group (n=40) and  healthy group (n=40). The EDL,TA and PER muscles thickness and CSA as well as PF thickness at calcaneal insertion, 2 cm and 4 cm distal to the insertion were evaluated by ultrasound in both groups.

Results: EDL thickness (p=0.007) and CSA (p=0.015) as well as PER muscles thickness (p=0.021) and CSA (p=0.005) showed statistically significant differences for a decrease in the favor the PFS group. Furthermore, PF thickness (p<0.001) measured at: calcaneal insertion, 2 cm, and 4 cm distal to the insertion showed an increase in the PFS group, showing statistically significant differences.

Conclusion: Thickness and CSA of both EDL and PER muscles were reduced in the patients with PFS. Moreover, the PF thickness along a 4 cm distal to the insertion is affected for an increase in the patients with PFS and reported to be a greater than 4 mm at calcaneal insertion.

 


Keywords


Plantar fasciitis, Plantar fascia, Ultrasound imaging, Extrinsic foot muscles.

Full Text:

PDF

References


Landorf B, Menz. B. Plantar heel pain and fasciitis. BMJ Clinical Evidence. 2008; 11: 1589–602

Riddle DL, Schappert SM. Volume of ambulatory care visits and patterns of care for patients diagnosed with plantar fasciitis: A national study of medical doctors. Foot and Ankle International. 2004; 25:303–10.

Thomas JL, Christensen JC, Kravitz SR, et al. The Diagnosis and Treatment of Heel Pain: A Clinical Practice Guideline-Revision 2010. Journal of Foot and Ankle Surgery. 2010; 49:329–40.

Grieve R, Palmer S. Physiotherapy for plantar fasciitis: a UK-wide survey of current practice. Physiotherapy. 2017;103:193–200.

Petraglia F, Ramazzina I, Costantino C. Plantar fasciitis in athletes: Diagnostic and treatment strategies. A systematic review. Muscles, Ligaments and Tendons Journal. 2017; 7:107–18.

Martin RL, Davenport TE, Reischl SF, et al. Heel pain - Plantar fasciitis: Revision 2014. Journal of Orthopaedic and Sports Physical Therapy. 2014; 44:A1–A33.

Priesand SJ, Schmidt BM, Ang L, et al. Plantar fasciitis in patients with type 1 and type 2 diabetes: A contemporary cohort study. Journal of Diabetes and its Complications. 2019; 33:107399.

Schneider HP, Baca JM, Carpenter BB, et al. American College of Foot and Ankle Surgeons Clinical Consensus Statement: Diagnosis and Treatment of Adult Acquired Infracalcaneal Heel Pain. The Journal of Foot and Ankle Surgery. 2018;57:370–81.

Lemont H, Ammirati KM, Usen N. Plantar fasciitis: A degenerative process (Fasciosis) without inflammation. Journal of the American Podiatric Medical Association. 2003; 93:234–37.

Wearing SC, Smeathers JE, Urry SR, et al. The Pathomechanics of Plantar Fasciitis. Sports Medicine. 2012; 36:585–11.

Salehi S, Shadmehr A, Olyaei G, et al. Ultrasonographic measurements of plantar fascia thickness and echogenicity in individuals with and without plantar fasciitis: Reliability and group differences. Foot. 2021; 49:101849.

Tsai WC, Chiu MF, Wang CL, et al. Ultrasound evaluation of plantar fasciitis. Scandinavian Journal of Rheumatology. 200; 29:255–59.

Wall JR, Harkness MA, Crawford A. Ultrasound diagnosis of plantar fasciitis. Foot and Ankle. 1993; 14:465–70.

Dell’Atti L. The role of ultrasonography in the diagnosis and management of idiopathic plantar fasciitis. Journal of Ultrasound. 2016; 19:161–66.

Chiquet M. Regulation of extracellular matrix gene expression by mechanical stress. Matrix Biology. 1999; 18:417–26.

Galloway MT, Lalley AL, Shearn JT. The role of mechanical loading in tendon development, maintenance, injury, and repair. Journal of Bone and Joint Surgery. 2013; 95:1620–28.

Angin S, Crofts G, Mickle KJ, Nester CJ. Ultrasound evaluation of foot muscles and plantar fascia in pes planus. Gait & Posture. 2014; 40:48–52.

Murley GS, Menz HB, Landorf KB. Foot posture influences the electromyographic activity of selected lower limb muscles during gait. Journal of Foot and Ankle Research. 2009; 2:1–9.

Otis JC, Deland JT, Lee S, Gordon J. Peroneus brevis is a more effective evertor than peroneus longus. Foot and Ankle International. 2004; 25:242–46.

Abdul SAK, Suppiah S, Ibrahim RM, et al. Prevalence of ultrasound-diagnosed non alcoholic fatty liver disease among rural indigenous population in malaysian and its association with biochemical and anthropometric measures. Malaysian Journal of Medicine and Health Sciences. 2021; 17:88–97

Romero-Morales C, Martín-Llantino PJ, Calvo-Lobo C, et al. Ultrasound evaluation of extrinsic foot muscles in patients with chronic non-insertional Achilles tendinopathy: A case-control study. Physical Therapy in Sport. 2019; 37:44–48.

Arif Khammas A, Mahmud R. Ultrasonographic measurements of the liver, gallbladder wall thickness, inferior vena cava, portal vein and pancreas in an Urban Region, Malaysia. Journal of Medical Ultrasound. 2021; 29:26–31.

Romero-Morales C, Martín-Llantino PJ, Calvo-Lobo C, et al. Intrinsic foot muscles morphological modifications in patients with Achilles tendinopathy: A novel case-control research study. Physical Therapy in Sport. 2019;40:208–12.

Khammas ASA, Hassan HA, Ibrahim RM, et al. Sonographic assessment of renal size and its correlation with anthropometric measures among indigenous population in peninsular Malaysia. Malaysian Journal of Medicine and Health Sciences. 2020; 16:138–45

Lobo CC, Morales CR, Sanz DR, et al. Ultrasonography Comparison of Peroneus Muscle Cross-sectional Area in Subjects With or Without Lateral Ankle Sprains. Journal of Manipulative and Physiological Therapeutics. 2016; 39:635–44.

Lobo CC, Marn AG, Sanz DR, et al. Ultrasound evaluation of intrinsic plantar muscles and fascia in hallux valgus A case-control study. Medicine (United States). 2016; 95:1–5.

Taniguchi M, Fukumoto Y, Kobayashi M, et al. Quantity and Quality of the Lower Extremity Muscles in Women with Knee Osteoarthritis. Ultrasound in Medicine & Biology. 2015; 41:2567–74.

Crofts G, Angin S, Mickle KJ, et al. Reliability of ultrasound for measurement of selected foot structures. Gait & Posture. 2014; 39:35–39.

Skovdal Rathleff M, Moelgaard C, Lykkegaard Olesen J. Intra- and interobserver reliability of quantitative ultrasound measurement of the plantar fascia. Journal of Clinical Ultrasound. 2011; 39:128–34.

López-López D, Becerro-de-Bengoa-Vallejo R, Losa-Iglesias ME, et al. Relationship between decreased subcalcaneal fat pad thickness and plantar heel pain. a case control study. Pain Physician. 2019; 22:109–116.

Calhoun JH, li F, Ledbetter BR, Viegas SF. A Comprehensive Study of Pressure Distribution in the Ankle Joint with Inversion and Eversion. Foot & Ankle International. 1994;15:125–133.

Canosa-Carro L, López-López D, García-Sanz F, et al. Features of Extrinsic Plantar Muscles in Patients with Plantar Fasciitis by Ultrasound Imaging: A Retrospective Case Control Research. Diagnostics. 2022; 12.

Maffulli N, Longo UG, Kadakia A, Spiezia F. Achilles tendinopathy. Foot and Ankle Surgery. 2020; 26:240–49.

Corrigan P, Cortes DH, Pohlig RT, Grävare Silbernagel K. Tendon Morphology and Mechanical Properties Are Associated With the Recovery of Symptoms and Function in Patients With Achilles Tendinopathy. Orthopaedic Journal of Sports Medicine. 2020; 8.

Nuri L, Obst SJ, Newsham-West R, Barrett RS. Three-dimensional morphology and volume of the free Achilles tendon at rest and under load in people with unilateral mid-portion Achilles tendinopathy. Experimental Physiology. 2018; 103:358–69.

Ooi CC, Schneider ME, Malliaras P, et al. Diagnostic Performance of Axial-Strain Sonoelastography in Confirming Clinically Diagnosed Achilles Tendinopathy: Comparison with B-Mode Ultrasound and Color Doppler Imaging. Ultrasound in Medicine and Biology. 2015; 41:15–25.

Maffulli N, Khan KM, Puddu G. Overuse tendon conditions: Time to change a confusing terminology. Arthroscopy. 1998; 14:840–43.

Romero-Morales C, Martín-Llantino PJ, Calvo-Lobo C, et al. Ultrasonography features of the plantar fascia complex in patients with chronic non-insertional achilles tendinopathy: A case-control study. Sensors (Switzerland). 2019; 19.

Stecco C, Corradin M, Macchi V, et al. Plantar fascia anatomy and its relationship with Achilles tendon and paratenon. Journal of Anatomy. 2013; 223:665–76.

Cook JL, Purdam CR. Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy. British Journal of Sports Medicine. 2009; 43:409–416.

Khammas ASA, Mahmud R, Hassan HA, et al. An assessment of plantar fascia with ultrasound findings in patients with plantar fasciitis: a systematic review. Journal of Ultrasound. 2022; 26:13-38

Maffulli N, Sharma P, Luscombe KL. Achilles Tendinopathy: Aetiology and Management. Journal of the Royal Society of Medicine. 2004; 97:472–76.

Karjalainen PT, Aronen HJ, Pihlajamäki HK, et al. Magnetic resonance imaging during healing of surgically repaired achilles tendon ruptures. American Journal of Sports Medicine. 1997; 25:164–71.




DOI: http://dx.doi.org/10.36162/hjr.v9i4.631

Refbacks

  • There are currently no refbacks.