Materiały źródłowe

• #1 Diagnosis and Treatment of Plantar Fasciitis | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0915/p676.html

  Plantar fasciitis, a self-limiting condition, is a common cause of heel pain in adults. It affects more than 1 million persons per year, and two-thirds of patients with plantar fasciitis will seek care from their family physician. Diagnosis is primarily based on history and physical examination. Patients may present with heel pain with their first steps in the morning or after prolonged sitting, and sharp pain with palpation of the medial plantar calcaneal region. […] Diagnostic imaging is rarely needed for the initial diagnosis of plantar fasciitis. Use of ultrasonography and magnetic resonance imaging is reserved for recalcitrant cases or to rule out other heel pathology; findings of increased plantar fascia thickness and abnormal tissue signal the diagnosis of plantar fasciitis. […] Diagnosis of plantar fasciitis is based on patient history, risk factors and physical examination findings. Most patients have heel pain and tightness after standing up from bed in the morning or after they have been seated for a prolonged time.

• #1 Patient education: Plantar fasciitis (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/heel-and-foot-pain-caused-by-plantar-fasciitis-beyond-the-basics

  Plantar fasciitis is one of the most common causes of heel and foot pain in adults. […] To diagnose plantar fasciitis, a health care provider will take a medical history and examine your feet to locate painful areas. This involves holding your foot in a flexed position with one hand and using the other hand to press on different parts of your sole (where the plantar fascia is located). […] If you have typical symptoms of plantar fasciitis, then no imaging tests (such as X-rays, ultrasound, or magnetic resonance imaging [MRI]) are required. This is the case for most people. In some instances, depending upon the nature and severity of pain as well as other individual factors, your provider may recommend imaging tests to determine if another issue (such as a fracture) is causing your pain.

• #1 How to diagnose plantar fasciitis | plantar fasciitis diagnosis

  https://www.fasciitis.com/plantar-fasciitis-diagnosis/

  The clinical history and physical examination is key in diagnosing plantar fasciitis. The most important features of the clinical history are morning stiffness and aggravation of pain on bending the foot upwards (dorsiflexion), which occurs in activities like standing on your toes or walking up stairs. The location of the pain is important in making the correct diagnosis. Plantar fasciitis pain is typically localized on the inside of the heel which is where the plantar fascia attaches. In some cases, tenderness may occur on the long arch of the foot or even the sole of the foot. Your doctor may squeeze or press on the inside of your heel to reproduce the pain and discomfort. Here are a few clinical symptoms that must be assessed during a clinical review: […] Pain that is felt with the first steps in the morning is usually considered a strong factor in making the clinical diagnosis of plantar fasciitis;

• #1 Plantar Fasciitis and Bone Spurs – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/plantar-fasciitis-and-bone-spurs/

  Plantar fasciitis (fashee-EYE-tiss) is one of the most common causes of pain on the bottom of the heel. Approximately 2 million patients are treated for this condition every year. […] Plantar fasciitis occurs when the plantar fascia, a strong band of tissue that supports the arch of your foot, becomes irritated and inflamed. […] After you describe your symptoms and discuss your concerns, your doctor will examine your foot. They will look for these signs: A high arch or flat foot, an area of maximum tenderness on the bottom of your foot, just in front of your heel bone, limited dorsiflexion, or „up” motion, in your ankle, the absence of symptoms from other conditions, such as insertional Achilles tendinitis, calcaneal (heel) stress fracture, or plantar nerve entrapment. […] Your doctor may order imaging tests to help make sure your heel pain is caused by plantar fasciitis and not another problem.

• #1 Plantar fasciitis: Symptoms, causes, and treatments – Harvard Health

  https://www.health.harvard.edu/pain/plantar-fasciitis-symptoms-causes-and-treatments

  Plantar fasciitis diagnosis […] If you suspect you have plantar fasciitis or are experiencing persistent foot pain, you should see your doctor for a proper diagnosis and treatment plan. Early intervention and appropriate management can help alleviate symptoms and improve your quality of life. […] Your doctor will examine your foot, looking for the following signs or risk factors of plantar fasciitis: an area of maximum tenderness on the bottom of your foot, just in front of your heel bone; a high arch or flat foot (a risk factor); limited dorsiflexion, or „up” motion, in your ankle; the absence of symptoms from other foot conditions that may share similar symptoms with plantar fasciitis, such as insertional Achilles tendinitis, calcaneal (heel) stress fracture, or plantar nerve entrapment.

• #1 Diagnosis and Management of Plantar Fasciitis

  https://www.degruyterbrill.com/document/doi/10.7556/jaoa.2014.177/html?lang=en&srsltid=AfmBOopPro9ZndwUcrXm_sjXLi5oky5eXHYingiybsTHOQdKaD5POn1J

  The aim of the present article is to provide the reader with an overview of the diagnosis and management of plantar fasciitis, a problem commonly encountered in the primary care setting. […] Plantar fasciitis is primarily a clinical diagnosis. Patients classically describe medial plantar heel pain on weight bearing, which is often most intense during their first few steps in the morning but tends to improve with rest. […] Classic physical examination findings suggestive of plantar fasciitis include reproducible pain with palpation of the plantar medial aspect of the heel and pain with passive dorsiflexion of the ankle and toes (windlass test). […] Diagnostic imaging is not recommended for the initial evaluation of plantar fasciitis. However, magnetic resonance images, triple-phase bone scans, or other imaging results may be required to rule out other considerations in the differential diagnosis, particularly when 4 to 6 months of nonsurgical treatment has failed or when the patient presents with atypical heel pain.

• #1 Windlass Test | Plantar Fasciitis Assessment | Heel Pain Exam

  https://www.physiotutors.com/wiki/windlass-test/

  The Windlass Test is a common orthopedic test to assess for plantar fasciitis, which is one of the leading causes of heel pain next to Achilles tendinopathy. […] De Garceau et al. (2003) found a sensitivity of 32 % and a Specificity of 100% for this test in the diagnosis of plantar fasciitis. […] This means that this test is not useful to exclude the presence of plantar fasciitis, but very useful to confirm the suspected pathology. […] This test is positive if the patient feels pain or increased pain at the insertion of the plantar fascia at the head of the first metatarsal. […] If the extension is not possible at the MTP joint this may indicate a Hallux Rigidus. […] It can be interesting to perform the Navicular Drop Test which assesses overpronation of the subtalar joint, which can be a contributing factor to plantar fasciitis. […] The association between diagnosis of plantar fasciitis and Windlass test results.

• #1 Diagnosis and Treatment of Plantar Fasciitis | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0915/p676.html

  Imaging can aid in the diagnosis of plantar fasciitis. Although not routinely needed initially, imaging can be used to confirm recalcitrant plantar fasciitis or to rule out other heel pathology. […] Ultrasonography is inexpensive and useful in ruling out soft tissue pathology of the heel. Findings that support the diagnosis of plantar fasciitis include proximal plantar fascia thickness greater than 4 mm and areas of hypoechogenicity. […] Magnetic resonance imaging, although expensive, is a valuable tool for assessing causes of recalcitrant heel pain. Diagnostic findings include increased proximal plantar fascia thickening with increased signal intensity on T2-weighted and short tau inversion recovery images.

• #1 Plantar Fasciitis – Bone, Joint, and Muscle Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/bone-joint-and-muscle-disorders/foot-and-ankle-problems/plantar-fasciitis

  Plantar fasciitis is pain originating from the dense band of tissue called the plantar fascia that extends from the bottom of the heel bone to the base of the toes (ball of the foot). […] The diagnosis is based on an examination of the foot and imaging tests. […] The doctor may make the diagnosis of plantar fasciitis by examining the foot. The diagnosis is confirmed if people have tenderness where the plantar fascia enters the heel bone. […] X-rays may show a heel spur protruding from the bottom front edge of the heel bone. However, people with plantar fasciitis often do not have heel spurs, and most people who do have heel spurs do not have pain, so the presence of a heel spur does not necessarily confirm plantar fasciitis and also does not mean the heel spur needs to be treated. […] Other diagnostic tests, such as magnetic resonance imaging (MRI), may be done if doctors suspect the person’s fascia is torn.

• #1 Plantar fasciitis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/plantar-fasciitis/diagnosis-treatment/drc-20354851

  Plantar fasciitis is diagnosed based on your medical history and physical exam. During the exam, your health care professional will check for areas of tenderness in your foot. The location of your pain can help determine its cause. […] Usually no tests are needed. Your health care professional might suggest an X-ray or MRI to make sure another problem, such as a stress fracture, is not causing your pain. […] Sometimes an X-ray shows a piece of bone sticking out from the heel bone. This is called a bone spur. In the past, these bone spurs were often blamed for heel pain and removed surgically. But many people who have bone spurs on their heels have no heel pain. […] For plantar fasciitis, basic questions to ask your health care team include: What tests do I need?

• #1 Plantar Fasciitis and Bone Spurs – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/plantar-fasciitis-and-bone-spurs/

  X-rays provide clear images of bones. They are useful in ruling out other causes of heel pain, such as fractures or arthritis. […] Heel spurs can be seen on an X-ray. A heel spur can be the result of longstanding (occurring for a long time) tension on the plantar fascia insertion (the spot on the heel bone where the plantar fascia attaches). However, most people who have bone spurs on their heels do not have heel pain. Since heel bone spurs are not the cause of plantar fasciitis, plantar fasciitis pain can be treated without removing the spur. […] Other imaging tests, such as magnetic resonance imaging (MRI) and ultrasound, are not routinely used to diagnose plantar fasciitis. They are rarely ordered. […] An MRI scan may be used if the heel pain is not relieved by initial treatment methods or if your doctor is concerned that a different problem is causing your heel pain.

• #1 Ultrasound for the diagnosis of plantar fasciitis | IJGM

  https://www.dovepress.com/musculoskeletal-ultrasound-for-the-diagnosis-of-plantar-fasciitis-an-a-peer-reviewed-fulltext-article-IJGM

  Objective: To evaluate the accuracy of musculoskeletal ultrasound measurement of plantar fascia thickness and shear wave elastography (SWE) calculation of Youngs modulus in the diagnosis of plantar fasciitis (PFis), and to explore whether it will have any impact on clinical decision-making, rather than just using established diagnostic methods of clinical symptoms and signs. […] The thickness of plantar fascia measured by musculoskeletal ultrasound and Youngs modulus calculated by SWE have high accuracy in diagnosing PFis, and the combined diagnosis of the two can improve the diagnostic accuracy of patients with PFis. […] The optimal cutoff value of the plantar fascia thickness calculated by the receiver operating characteristic was 3.15 mm (sensitivity: 100.0%, specificity: 81.3%), and the area under the curve was 0.925.

• #1 Ultrasound for the diagnosis of plantar fasciitis | IJGM

  https://www.dovepress.com/musculoskeletal-ultrasound-for-the-diagnosis-of-plantar-fasciitis-an-a-peer-reviewed-fulltext-article-IJGM

  The optimal cutoff value of Youngs modulus calculated by receiver operating characteristic is 63.24 kPa (sensitivity: 78.3%, specificity: 92.2%), and the area under the curve was 0.917. […] When the plantar fascia thickness measurement method and the Youngs modulus method are combined for diagnosis, the area under the curve is 0.973 (sensitivity: 93.3%, specificity: 93.8%), and the diagnostic accuracy is higher than when the two methods are diagnosed separately. […] This study showed that the method of measuring the thickness of plantar fascia by ultrasound and the Youngs modulus calculated by shear wave elastography has a high diagnostic value for PFis, and the combined diagnosis of the two is more accurate than the separate diagnosis of the two.

• #1 Plantar fasciitis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/plantar-fasciitis?lang=us

  Plantar fasciitis (rare plural: plantar fasciitides) refers to inflammation of the plantar fascia of the foot. It is considered the most common cause of heel pain. […] Ultrasound is often the initial imaging modality of choice; it typically shows increased thickness of the fascia (4.5 mm) and a hypoechoic fascia. […] Signal characteristics of affected tissues include: T1/PD: intermediate signal, T2: high signal, STIR: very sensitive in the detection of both fascial and perifascial edema, which appear as poorly marginated areas of high signal intensity. […] Management options are usually conservative. Local injection of steroids +/- local anesthetic may be useful to manage symptoms. Ultrasound-guided steroid injection has been shown to be effective in short-term (four-week) pain relief with reduced thickness of the plantar fascia at three months.

• #1 Plantar Fasciitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK431073/

  Plantar fasciitis is a clinical diagnosis, and imaging is unnecessary. A provider may consider obtaining x-rays or ultrasound evaluation if history or physical exam indicates other injuries or conditions or the patient fails to improve after a reasonable amount of time. X-rays and ultrasound evaluation may show calcifications in the soft tissues or heel spurs on the inferior aspect of the heel. Additionally, ultrasound may show thickening and swelling of the plantar fascia, a typical feature. If the patient is not responding to conservative therapy after more extended periods, then the provider may consider ordering magnetic resonance imaging to evaluate for tears, stress fractures, or osteochondral defects. […] The presence of plantar fasciitis can be identified on magnetic resonance imaging by the thickening of the plantar fascia and increased signal on delayed and short tau inversion recovery images. Technetium scintigraphy is another diagnostic method that can successfully locate the inflammatory focus and exclude the presence of a stress fracture.

• #1 Plantar fasciitis – Wikipedia

  https://en.wikipedia.org/wiki/Plantar_fasciitis

  Plantar fasciitis is usually diagnosed by a health care provider after consideration of a person’s presenting history, risk factors, and clinical examination. Palpation along the inner aspect of the heel bone on the sole may elicit tenderness during the physical examination. The foot may have limited dorsiflexion due to excessive tightness of the calf muscles or the Achilles tendon. Dorsiflexion of the foot may elicit the pain due to stretching of the plantar fascia with this motion. Diagnostic imaging studies are not usually needed to diagnose plantar fasciitis. […] Occasionally, a physician may decide imaging studies (such as X-rays, diagnostic ultrasound, or MRI) are warranted to rule out serious causes of foot pain. Other diagnoses that are typically considered include fractures, tumors, or systemic disease if plantar fasciitis pain fails to respond appropriately to conservative medical treatments. Bilateral heel pain or heel pain in the context of a systemic illness may indicate a need for a more in-depth diagnostic investigation. Under these circumstances, diagnostic tests such as a CBC or serological markers of inflammation, infection, or autoimmune disease such as C-reactive protein, erythrocyte sedimentation rate, anti-nuclear antibodies, rheumatoid factor, HLA-B27, uric acid, or Lyme disease antibodies may also be obtained. Neurological deficits may prompt an investigation with electromyography to check for damage to the nerves or muscles.

• #1 Plantar Heel Pain Workup: Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/1233178-workup

  Generally, plantar fasciitis is a clinical diagnosis; laboratory and imaging studies are rarely indicated. However, heel pain, especially when it is bilateral, can be a rare primary presenting sign of systemic inflammatory disorders. If a patient presents with bilateral heel pain in association with systemic symptoms, the blood should be screened for inflammatory markers, such as the erythrocyte sedimentation rate (ESR), human leukocyte antigen (HLA)-B27, rheumatoid factor (RF), and antinuclear antibodies (ANA). […] Heel spurs develops in the origin of the flexor digitorum brevis in approximately 50% of patients with proximal plantar fasciitis. The etiology is thought to be repetitive traction that leads to collagen degeneration, angiofibroblastic hyperplasia, and matrix calcification. […] However, a report by Johal and Milner suggests a significant association between plantar fasciitis and calcaneal spur formation.

• #1 “Diagnosis and Management of Plantar Fasciitis”: Evidence Based Clinical Review – OMM Education Series

  https://ommeducation.com/2015/11/diagnosis-and-management-of-plantar-fasciitis-evidence-based-clinical-review/

  The telltale findings on physical exam include tenderness to deep palpation on the plantar medial aspect of the heel and pain with passive dorsiflexion of the ankle and toes. […] 85-90% of patients with plantar fasciitis can be treated successfully with conservative treatment which may include: OMM, stretching, range of motion, orthoses, posterior tension night splints, ultrasound, massage, extracorporeal shock wave therapy, and NSAID’s. […] When it comes to invasive therapies corticosteroid injection should be considered with caution due to an unfavorable risk to benefit ratio. […] Surgery, which involves a partial or complete plantar fasciotomy, should only be considered as a last resort after 6 to 12 months of failed conservative multimodal therapies. […] The listed differential diagnoses to consider in someone with chronic heel and plantar pain that is not responding to treatments are: Calcaneal Stress Fracture, Subtalar or Talonavicular arthritis, Fat Pad Atrophy, Insertional Achilles Tendonitis, Retrocalcaneal Bursitis, Tarsal Tunnel Syndrome, S1 Radiculopathy, Peripheral Neuropathy, Lateral Plantar Nerve or Medial Calcaneal Nerve Entrapment.

• #1 Plantar Fasciitis – Diagnosis and Specialized Heel Pain Treatment

  https://www.fasciitis.com/

  The diagnosis of plantar fasciitis is a clinical one. Further investigations depend on the clinical picture. Don’t forget to exclude Baxter’s Entrapment! […] We specialize in the non-surgical treatment of Plantar Fasciitis. […] We also offer diagnosis and treatment of Baxter’s Entrapment. Baxter’s entrapment can appear just like Plantar Fasciitis. In fact, clinically it can be nearly impossible to differentiate them. The only way to tell them apart is by an Ultrasound Guided Diagnostic Injection or MRI. Yet the treatments are completely different. Baxter’s Entrapment can be treated by an ultrasound Guided Ablation procedure.

• #1 Plantar Fasciitis: Symptoms, Causes & Treatment Options

  https://my.clevelandclinic.org/health/diseases/14709-plantar-fasciitis

  The treatments listed above are usually all youll need to relieve your symptoms and treat plantar fasciitis. Its very rare to need surgery. […] Your healthcare provider or surgeon will tell you which type of surgery youll need to treat plantar fasciitis. […] Visit a healthcare provider if: You have pain in your heel or foot that doesnt get better on its own in a week. Your symptoms dont improve after two weeks of treatment. […] Talk to a healthcare provider if youre experiencing pain in your heel or foot that doesnt get better on its own in a week. Theyll help you find at-home treatments to reduce the pain and inflammation in your foot.

• #1 Plantar fasciitis

  https://www2.hse.ie/conditions/plantar-fasciitis/

  use soft insoles or heel pads in your shoes […] regular gentle stretching exercises […] exercises that do not put pressure on your feet, such as swimming […] take paracetamol. Contact your GP if: the pain is severe or stopping you doing normal activities […] the pain is getting worse or keeps coming back […] the pain has not improved after treating it yourself for 2 weeks […] you have any tingling or loss of feeling in your foot […] you have diabetes foot problems can be more serious if you have diabetes. Your GP might refer you to a physiotherapist for exercises or to see a foot specialist (podiatrist). They can recommend things like insoles and the right shoes to wear.

• #1 Diagnosis and Management of Plantar Fasciitis

  https://www.degruyterbrill.com/document/doi/10.7556/jaoa.2014.177/html?lang=en&srsltid=AfmBOopPro9ZndwUcrXm_sjXLi5oky5eXHYingiybsTHOQdKaD5POn1J

  Plantar fasciitis is primarily a clinical diagnosis that requires a thorough history and physical examination because of the breadth of the differential diagnosis. […] Female patients, middle-aged patients, long-distance runners, military personnel, obese patients, and individuals with a cavus or planus foot deformity are at an increased risk for developing plantar fasciitis. […] Nonsteroidal anti-inflammatory drugs, focused stretching, footwear modifications, and over-the-counter orthotics are recommended for the initial management of plantar fasciitis. […] Approximately 85% to 90% of patients with plantar fasciitis can be successfully treated without surgery. […] A combination of conservative treatments is successful in most cases and should include NSAIDs, a proper stretching regimen, night splints, and, if there is no relief after 6 to 12 months, referral to a specialist.

• #2 Diagnosis and Management of Plantar Fasciitis

  https://www.degruyterbrill.com/document/doi/10.7556/jaoa.2014.177/html?lang=en&srsltid=AfmBOopPro9ZndwUcrXm_sjXLi5oky5eXHYingiybsTHOQdKaD5POn1J

  Plantar fasciitis, a chronic degenerative process that causes medial plantar heel pain, is responsible for approximately 1 million physician visits each year. […] The authors provide an overview of the diagnosis and management of a common problem encountered in the primary care setting. Routine imaging is not initially recommended for the evaluation of plantar fasciitis but may be required to rule out other pathologic conditions. Overall, plantar fasciitis carries a good prognosis when patients use a combination of several conservative treatment modalities. Occasionally, referral to a specialist may be necessary. […] The initial evaluation of plantar fasciitis often occurs in the primary care setting. Although the diagnosis is often straightforward, an extensive list of alternative diagnoses may need to be ruled out. Effective treatment is predicated on the modification of risk factors and the implementation of an evidence-based treatment approach. Ultimately, a good prognosis is expected.

• #2 Plantar Fasciitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK431073/

  Plantar fasciitis is a clinical diagnosis, and imaging is unnecessary. A provider may consider obtaining x-rays or ultrasound evaluation if history or physical exam indicates other injuries or conditions or the patient fails to improve after a reasonable amount of time. X-rays and ultrasound evaluation may show calcifications in the soft tissues or heel spurs on the inferior aspect of the heel. Additionally, ultrasound may show thickening and swelling of the plantar fascia, a typical feature. If the patient is not responding to conservative therapy after more extended periods, then the provider may consider ordering magnetic resonance imaging to evaluate for tears, stress fractures, or osteochondral defects. […] The presence of plantar fasciitis can be identified on magnetic resonance imaging by the thickening of the plantar fascia and increased signal on delayed and short tau inversion recovery images. Technetium scintigraphy is another diagnostic method that can successfully locate the inflammatory focus and exclude the presence of a stress fracture.

• #2 Plantar fasciitis: Symptoms, causes, and treatments – Harvard Health

  https://www.health.harvard.edu/pain/plantar-fasciitis-symptoms-causes-and-treatments

  Plantar fasciitis diagnosis […] If you suspect you have plantar fasciitis or are experiencing persistent foot pain, you should see your doctor for a proper diagnosis and treatment plan. Early intervention and appropriate management can help alleviate symptoms and improve your quality of life. […] Your doctor will examine your foot, looking for the following signs or risk factors of plantar fasciitis: an area of maximum tenderness on the bottom of your foot, just in front of your heel bone; a high arch or flat foot (a risk factor); limited dorsiflexion, or „up” motion, in your ankle; the absence of symptoms from other foot conditions that may share similar symptoms with plantar fasciitis, such as insertional Achilles tendinitis, calcaneal (heel) stress fracture, or plantar nerve entrapment.

• #2 How to diagnose plantar fasciitis | plantar fasciitis diagnosis

  https://www.fasciitis.com/plantar-fasciitis-diagnosis/

  Plantar fasciitis pain and stiffness resolves with activity. On the contrary, tibial nerve entrapment (Tarsal tunnel syndrome) pain and calcaneal stress fracture pain are worsened with walking; […] Plantar fascia tenderness is truly at its worst toward the end of the day; […] Bilateral plantar fasciitis is reported in approximately 30% cases; and, […] Plantar fasciitis patients do not usually report night pain or feelings of and pins & needles. Presence of these two suggest other causes of heel pain such as neuralgia or neuropathies, tumors, tarsal tunnel syndrome and infections. […] A careful examination of the spine, lower extremities and neurological function helps to diagnose the cause of foot pain. The examination should include discovering the point of maximum tenderness. Frequently, the pain and discomfort can be reproduced standing on your toes. Any abnormalities of foot structure such as flat feet (pes planus) or high arches (pes cavus) should also be assessed during clinical examination. The Achilles tendon must be evaluated in all cases. Shortening of the Achilles tendon (Achilles tendon contracture) is reported in over 80% of cases of plantar fasciitis.

• #2 Plantar Fasciitis Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/86143-clinical

  Other maneuvers that may reproduce the pain of plantar fasciitis include passive dorsiflexion of the toes, which is sometimes called the windlass test, and having the patient stand on the tiptoes and toe-walk. […] To ensure that the patient is not presenting with retrocalcaneal bursitis or Achilles tendonitis, the clinician also should palpate the posterior aspect of the heel and ankle to look for tenderness. […] A full musculoskeletal examination, including range of motion of hind-foot joints and medial-to-lateral squeeze of the calcaneus, aids further in diagnosis. […] Tarsal tunnel syndrome can be ruled out by percussing over the tarsal tunnel behind the medial malleolus. […] The vascular examination includes palpation of the foot and ankle pulses. […] In patients with plantar fasciitis, the results of all of these tests are within the reference range.

• #2 Diagnosis and Management of Plantar Fasciitis

  https://www.degruyterbrill.com/document/doi/10.7556/jaoa.2014.177/html?lang=en&srsltid=AfmBOopPro9ZndwUcrXm_sjXLi5oky5eXHYingiybsTHOQdKaD5POn1J

  The aim of the present article is to provide the reader with an overview of the diagnosis and management of plantar fasciitis, a problem commonly encountered in the primary care setting. […] Plantar fasciitis is primarily a clinical diagnosis. Patients classically describe medial plantar heel pain on weight bearing, which is often most intense during their first few steps in the morning but tends to improve with rest. […] Classic physical examination findings suggestive of plantar fasciitis include reproducible pain with palpation of the plantar medial aspect of the heel and pain with passive dorsiflexion of the ankle and toes (windlass test). […] Diagnostic imaging is not recommended for the initial evaluation of plantar fasciitis. However, magnetic resonance images, triple-phase bone scans, or other imaging results may be required to rule out other considerations in the differential diagnosis, particularly when 4 to 6 months of nonsurgical treatment has failed or when the patient presents with atypical heel pain.

• #2 Plantar fasciitis – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/487

  Plantar fasciitis is one of the most common causes of heel and foot pain in adults. […] Diagnosis is usually based on a thorough history and physical examination. There is no laboratory test that can confirm or rule out the diagnosis. […] Plain film x-rays are of little benefit in typical cases, although they may be helpful in ruling out other pathology. […] Nonsurgical treatment is the standard of care for acute heel pain, although 10% of cases are recalcitrant and unresponsive to nonsurgical care after 12 months. […] Conservative treatment involves combination therapy (e.g., heel padding, shoe changes, low-Dye strapping, nonsteroidal anti-inflammatory drugs, and stretching exercises). […] Key diagnostic factors include heel pain (stabbing or knife-like), pain relieved with rest, poststatic dyskinesia, and pain exacerbated by standing and other activities of daily living.

• #2 Plantar fasciitis – Wikipedia

  https://en.wikipedia.org/wiki/Plantar_fasciitis

  An incidental finding associated with this condition is a heel spur, a small bony calcification on the calcaneus (heel bone), which can be found in up to 50% of those with plantar fasciitis. In such cases, it is the underlying plantar fasciitis that produces the heel pain, and not the spur itself. The condition is responsible for the creation of the spur though the clinical significance of heel spurs in plantar fasciitis remains unclear.

• #2 Plantar Fasciitis (or Fasciopathy) Diagnosis & Treatment | PridePlus Health

  https://prideplus.com.au/plantar-fasciitis/

  If there is more information required or potentially a couple of injuries happening at the same time then imaging can be useful. For example, it’s quite common for both plantar fasciitis and a heel fat pad injury to occur at the same time. […] The two kinds of imaging that are useful are magnetic resonance imaging (MRI) or ultrasound imaging. An MRI is able to show the plantar fascia and surrounding soft tissues as well as the heel bone itself. […] Ultrasound imaging in the hands of a skilled sonographer can be exceptional at showing the quality of the plantar fascia. Signs such as the thickness of your fascia, small tears, scarring or vascular growth can be seen clearly on ultrasound imaging. […] A modality that really doesn’t help with most forms of heel pain and plantar fasciitis, in particular, are plain film X-rays. X-ray imaging is great at showing up bone pathology however heel pain is very rarely related to bone pathology and even when it is, as, in the case of a calcaneal stress fracture, these injuries are not likely to show on a plain film x-ray.

• #2 Plantar Fasciitis and Bone Spurs – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/plantar-fasciitis-and-bone-spurs/

  X-rays provide clear images of bones. They are useful in ruling out other causes of heel pain, such as fractures or arthritis. […] Heel spurs can be seen on an X-ray. A heel spur can be the result of longstanding (occurring for a long time) tension on the plantar fascia insertion (the spot on the heel bone where the plantar fascia attaches). However, most people who have bone spurs on their heels do not have heel pain. Since heel bone spurs are not the cause of plantar fasciitis, plantar fasciitis pain can be treated without removing the spur. […] Other imaging tests, such as magnetic resonance imaging (MRI) and ultrasound, are not routinely used to diagnose plantar fasciitis. They are rarely ordered. […] An MRI scan may be used if the heel pain is not relieved by initial treatment methods or if your doctor is concerned that a different problem is causing your heel pain.

• #2 Plantar Heel Pain Workup: Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/1233178-workup

  Generally, plantar fasciitis is a clinical diagnosis; laboratory and imaging studies are rarely indicated. However, heel pain, especially when it is bilateral, can be a rare primary presenting sign of systemic inflammatory disorders. If a patient presents with bilateral heel pain in association with systemic symptoms, the blood should be screened for inflammatory markers, such as the erythrocyte sedimentation rate (ESR), human leukocyte antigen (HLA)-B27, rheumatoid factor (RF), and antinuclear antibodies (ANA). […] Heel spurs develops in the origin of the flexor digitorum brevis in approximately 50% of patients with proximal plantar fasciitis. The etiology is thought to be repetitive traction that leads to collagen degeneration, angiofibroblastic hyperplasia, and matrix calcification. […] However, a report by Johal and Milner suggests a significant association between plantar fasciitis and calcaneal spur formation.

• #2 Plantar fasciitis – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/487

  Other diagnostic factors include pain exacerbated by walking barefoot or in nonsupportive footwear, pain improved with nonsteroidal anti-inflammatory drug (NSAID) use, no history of acute injury to the heel, self-limiting pain, unilateral heel pain, positive dorsiflexion-eversion test, positive Windlass test, and negative Tinel sign. […] 1st tests to order include foot x-ray. […] Tests to consider include technetium (Tc-MDP 3-phase) bone scan, MRI, HLA-B27, rheumatoid factor, and ultrasound.

• #2 Plantar Fasciitis Diagnosis

  https://www.sports-health.com/sports-injuries/ankle-and-foot-injuries/plantar-fasciitis-diagnosis

  Lab testing (e.g. testing a patients blood sample) is not considered routine, but it may be done to rule out systemic illness, such as rheumatoid arthritis. Some experts also suggest nerve testing, such as an electromyography (EMG), to rule out nerve disorders such as Baxters Neuropathy that may cause heel pain.

• #2 Consensus statements and guideline for the diagnosis and management of plantar fasciitis in Singapore – Annals Singapore

  https://annals.edu.sg/consensus-statements-and-guideline-for-the-diagnosis-and-management-of-plantar-fasciitis-in-singapore/

  Tenderness over the medial calcaneal tubercle and discomfort with passive or active dorsiflexion of the hallux are characteristic physical findings. […] Statement 2: Other differential diagnoses of plantar heel pain should be considered before the conclusion of the diagnosis of plantar fasciitis. […] There are multiple causes for plantar heel pain. […] Statement 3: Bedside ultrasonography can be useful to confirm the diagnosis of plantar fasciitis. […] Although bedside ultrasonography (US) is not required for initial PF diagnosis and management, it can assist clinicians with visualising the foot anatomy in real time and confirming the diagnosis of PF. […] Statement 4: If the history and physical examinations are indicative of plantar fasciitis, radiographic imaging has a limited role in the diagnosis of plantar fasciitis.

• #2 Diagnosis and Management of Plantar Fasciitis

  https://www.degruyterbrill.com/document/doi/10.7556/jaoa.2014.177/html?lang=en&srsltid=AfmBOopPro9ZndwUcrXm_sjXLi5oky5eXHYingiybsTHOQdKaD5POn1J

  Plantar fasciitis is primarily a clinical diagnosis that requires a thorough history and physical examination because of the breadth of the differential diagnosis. […] Female patients, middle-aged patients, long-distance runners, military personnel, obese patients, and individuals with a cavus or planus foot deformity are at an increased risk for developing plantar fasciitis. […] Nonsteroidal anti-inflammatory drugs, focused stretching, footwear modifications, and over-the-counter orthotics are recommended for the initial management of plantar fasciitis. […] Approximately 85% to 90% of patients with plantar fasciitis can be successfully treated without surgery. […] A combination of conservative treatments is successful in most cases and should include NSAIDs, a proper stretching regimen, night splints, and, if there is no relief after 6 to 12 months, referral to a specialist.

• #2 Consensus statements and guideline for the diagnosis and management of plantar fasciitis in Singapore – Annals Singapore

  https://annals.edu.sg/consensus-statements-and-guideline-for-the-diagnosis-and-management-of-plantar-fasciitis-in-singapore/

  Plantar fasciitis (PF) is a common cause of heel pain among the general population. […] These consensus statements and guideline were developed to streamline and improve the management of PF, covering key aspects such as diagnosis, investigations, risk factors, treatment modalities, monitoring and return to work/play. […] PF can be diagnosed through history and physical examinations and bedside ultrasonography (US). […] Differentiating other causes of plantar heel pain should prompt further investigation with imaging. […] Statement 1: Plantar fasciitis is diagnosed via history and physical examinations. […] PF is diagnosed based on clinical assessment. […] Patients usually present with plantar heel pain, particularly worse with the first steps in the morning or after extended periods of inactivity.

• #2 Ultrasound for the diagnosis of plantar fasciitis | IJGM

  https://www.dovepress.com/musculoskeletal-ultrasound-for-the-diagnosis-of-plantar-fasciitis-an-a-peer-reviewed-fulltext-article-IJGM

  The optimal cutoff value of Youngs modulus calculated by receiver operating characteristic is 63.24 kPa (sensitivity: 78.3%, specificity: 92.2%), and the area under the curve was 0.917. […] When the plantar fascia thickness measurement method and the Youngs modulus method are combined for diagnosis, the area under the curve is 0.973 (sensitivity: 93.3%, specificity: 93.8%), and the diagnostic accuracy is higher than when the two methods are diagnosed separately. […] This study showed that the method of measuring the thickness of plantar fascia by ultrasound and the Youngs modulus calculated by shear wave elastography has a high diagnostic value for PFis, and the combined diagnosis of the two is more accurate than the separate diagnosis of the two.

• #2 Plantar Fasciitis: Symptoms, Causes & Treatment Options

  https://my.clevelandclinic.org/health/diseases/14709-plantar-fasciitis

  The treatments listed above are usually all youll need to relieve your symptoms and treat plantar fasciitis. Its very rare to need surgery. […] Your healthcare provider or surgeon will tell you which type of surgery youll need to treat plantar fasciitis. […] Visit a healthcare provider if: You have pain in your heel or foot that doesnt get better on its own in a week. Your symptoms dont improve after two weeks of treatment. […] Talk to a healthcare provider if youre experiencing pain in your heel or foot that doesnt get better on its own in a week. Theyll help you find at-home treatments to reduce the pain and inflammation in your foot.

• #3 Plantar Fasciitis: Evidence-Based Review of Diagnosis and Therapy | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/1201/p2237.html

  Plantar fasciitis causes heel pain in active as well as sedentary adults of all ages. […] A diagnosis of plantar fasciitis is based on the patients history and physical findings. […] Diagnosis of plantar fasciitis is based on the patients history and on results of the physical examination. Patients typically present with inferior heel pain on weight bearing, and the pain often persists for months or even years. […] The patient usually has tenderness around the medial calcaneal tuberosity at the plantar aponeurosis. […] A number of other conditions cause heel pain; most of these can be distinguished from plantar fasciitis by a history and physical examination. […] Diagnostic imaging is not helpful in diagnosing plantar fasciitis, but it should be considered if another diagnosis is strongly suspected.

Zobacz więcej