In-Season Management of Acute and Subacute Sports Foot Injuries.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Disclosure The authors have nothing to disclose. 10. J Foot Ankle Res. 2022 Jan 22;15(1):4. doi: 10.1186/s13047-021-00507-2. Medical imaging for plantar heel pain: a systematic review and meta-analysis. Drake C(1), Whittaker GA(2)(3), Kaminski MR(2), Chen J(4), Keenan AM(5), Rathleff MS(6)(7)(8), Robinson P(5), Landorf KB(2)(3). Author information: (1)Physiotherapy Department, Mid-Yorkshire Hospitals NHS Trust, Wakefield, England. chris.drake1@nhs.net. (2)Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Victoria, 3086, Australia. (3)La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Victoria, 3086, Australia. (4)Department of Rehabilitation, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore. (5)NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, School of Healthcare, University of Leeds, Leeds, England. (6)Center for General Practice at Aalborg University, Fyrkildevej 7, 9220, Aalborg East, Denmark. (7)Department of Occupational Therapy and Physiotherapy, Aalborg University Hospital, Hobrovej 18-22, 9100, Aalborg, Denmark. (8)Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark. BACKGROUND: 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. METHODS: This 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. RESULTS: Forty-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). CONCLUSIONS: People 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. © 2021. The Author(s). DOI: 10.1186/s13047-021-00507-2 PMCID: PMC8783477