Treatment of proximal plantar fasciitis with ultrasound-guided steroid injection Wen-Chung Tsai, MD, Chung-Li Wang, MD, PhD, Fuk-Tan Tang, MD, Tsz-Ching.

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Treatment of proximal plantar fasciitis with ultrasound-guided steroid injection Wen-Chung Tsai, MD, Chung-Li Wang, MD, PhD, Fuk-Tan Tang, MD, Tsz-Ching Hsu, MD, Kuang-Hung Hsu, PhD, May-Kuen Wong, MD Archives of Physical Medicine and Rehabilitation Volume 81, Issue 10, Pages 1416-1421 (October 2000) DOI: 10.1053/apmr.2000.9175 Copyright © 2000 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig. 1 Longitudinal sonogram of the plantar fascia. (A) Normal fascia with regular echogenic appearance (arrowheads) attached proximally to calcaneus (C). (B) Inflamed proximal plantar fascia (arrowheads) is grossly thickened and hypoechoic. Archives of Physical Medicine and Rehabilitation 2000 81, 1416-1421DOI: (10.1053/apmr.2000.9175) Copyright © 2000 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig. 2 Compression-relaxation device. The upper adjustable component is comprised of A1, manual knob; A2, positioning unit; A3, adapter to connect push-pull scale and positioning unit; A4, push-pull scale; A5, adapter to connect the push-pull scale and ultrasound transducer; and A6, ultrasound transducer. The lower fixation frame contains B1, foot placement board with nylon fixation strap; and B2, ankle fixator, adjustable to different heights. Archives of Physical Medicine and Rehabilitation 2000 81, 1416-1421DOI: (10.1053/apmr.2000.9175) Copyright © 2000 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig. 3 Longitudinal sonogram of the asymptomatic heel pad (A) without any loading weight and (B) under a 3-kg loading weight. Heel pad thickness is the shortest distance between the heel's superficial surface and the calcaneal soft tissue junction. Upper arrowheads indicate sole skin; lower arrowheads indicate cortex of calcaneal tuberosity. Archives of Physical Medicine and Rehabilitation 2000 81, 1416-1421DOI: (10.1053/apmr.2000.9175) Copyright © 2000 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig. 4 An example of the load-displacement curve of the heel pad. The upper curve is the loading curve and the lower curve is the unloading curve. The energy dissipation ratio is the area between the loading curve and the unloading curve divided by the area under the loading curve to the x axis. Archives of Physical Medicine and Rehabilitation 2000 81, 1416-1421DOI: (10.1053/apmr.2000.9175) Copyright © 2000 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig. 5 Ultrasound-guided injection technique. (A) The needle follows the direction of the arrow and is inserted into (B) the inflamed proximal plantar fascia (arrows) under real-time ultrasound guidance. Arrow indicates point of needle entry. Archives of Physical Medicine and Rehabilitation 2000 81, 1416-1421DOI: (10.1053/apmr.2000.9175) Copyright © 2000 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions