Abstract
BackgroundMedical imaging can be used to assist with the diagnosis of plantar heel pain. The aim of this study was to synthesise medical imaging features associated with plantar heel pain.MethodsThis systematic review and meta-analysis conducted searches in MEDLINE, CINAHL, SPORTDiscus, Embase and the Cochrane Library from inception to 12th February 2021. Peer-reviewed articles of cross-sectional observational studies written in English that compared medical imaging findings in adult participants with plantar heel pain to control participants without plantar heel pain were included. Study quality and risk of bias was assessed using the National Institutes of Health quality assessment tool for observational cohort and cross-sectional studies. Sensitivity analyses were conducted where appropriate to account for studies that used unblinded assessors.ResultsForty-two studies (2928 participants) were identified and included in analyses. Only 21% of studies were rated ‘good’ on quality assessment. Imaging features associated with plantar heel pain included a thickened plantar fascia (on ultrasound and MRI), abnormalities of the plantar fascia (on ultrasound and MRI), abnormalities of adjacent tissue such as a thickened loaded plantar heel fat pad (on ultrasound), and a plantar calcaneal spur (on x-ray). In addition, there is some evidence from more than one study that there is increased hyperaemia within the fascia (on power Doppler ultrasound) and abnormalities of bone in the calcaneus (increased uptake on technetium-99 m bone scan and bone marrow oedema on MRI).ConclusionsPeople with plantar heel pain are more likely to have a thickened plantar fascia, abnormal plantar fascia tissue, a thicker loaded plantar heel fat pad, and a plantar calcaneal spur. In addition, there is some evidence of hyperaemia within the plantar fascia and abnormalities of the calcaneus. Whilst these medical imaging features may aid with diagnosis, additional high-quality studies investigating medical imaging findings for some of these imaging features would be worthwhile to improve the precision of these findings and determine their clinical relevance.
Highlights
Medical imaging can be used to assist with the diagnosis of plantar heel pain
One Magnetic resonance imaging (MRI) study reported the number of people with plantar fascia thickness > 4 mm [49]; this study found 15 (75%) of the Plantar heel pain (PHP) participants and none (0%) of the control participants presented with this finding
This systematic review investigated medical imaging features associated with PHP
Summary
Medical imaging can be used to assist with the diagnosis of plantar heel pain. The aim of this study was to synthesise medical imaging features associated with plantar heel pain. A recent study estimated the prevalence of PHP was 9.6% of the population aged 50 years or older, with 7.9% of the population reporting symptoms classified as disabling [2]. Often thought to be a short to medium term self-limiting condition, one study recently documented that symptoms can last much longer than originally thought – up to 10 years for half of the participants [10]. Early in the patient journey, the diagnosis of the condition and cause of the symptoms can be somewhat confusing for patients. Imaging can aid the identification of the tissues involved, which has the potential to target management more effectively
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have