Effectiveness of Device-Assisted Ultrasound-Guided Steroid Injection for Treating Plantar Fasciitis

Objective: The aim of this study was to investigate the effectiveness of device-assisted ultrasound-guided steroid injection for treating plantar fasciitis. Design: An ultrasound-guided injection device designed with space for securing a transducer and syringe was used to guide steroid injection. Patients with unilateral plantar fasciitis were enrolled and randomly divided into device-assisted ultrasound-guided and palpation-guided groups. Pain intensity was measured using a visual analog scale and tenderness threshold. Ultrasound and pain intensity evaluations were performed before injection and at 3 wks and at 3 mos post-injection. Betamethasone (7 mg) and 1% lidocaine (0.5 ml) were injected into the inflamed plantar fascia. Results: Thirty-three patients who received either device-assisted ultrasound-guided or palpation-guided injection had significantly lower visual analog scale scores (P < 0.001) and higher tenderness threshold (P < 0.01) postinjection. However, the device-assisted group had higher tenderness threshold (9.02 +/- 1.38 vs. 7.18 +/- 2.11 kg/cm(2); P = 0.007), lower visual analog scale score (1.88 +/- 2.13 vs. 3.63 +/- 2.60; P = 0.046), and lower hypoechogenicity incidence in the plantar fascia (3/16 vs. 9/16; P = 0.033) than the palpation-guided group did at 3 mos postinjection. The heel pad was significantly thin (P = 0.004) in the palpation-guided group postinjection. Conclusions: Device-assisted ultrasound-guided injection for treating plantar fasciitis results in better therapeutic outcomes than palpation-guided injection does.