One of the main reasons our podiatry clinic invested in a diagnostic ultrasound system was to help aid diagnosis of plantar heel pain. This is one of the most common conditions podiatrists treat and it can often be complex to diagnose with many differential diagnoses.
A common mistake for medical practitioners is to assume all cases of plantar heel pain are caused by plantar fasciitis. Often there are other causes and in complex cases, multiple causes. Some common other causes of plantar heel pain include: plantar fascia tears, nerve entrapment, heel fat pad atrophy and heel bone stress.
Diagnostic ultrasound helps measure plantar fascia strain
Using diagnostic ultrasound our podiatrists can check for plantar fasica tears as well as measure plantar fascia thickness and heel pad thickness. In cases of plantar fascittis (excess strain of the plantar fascia) research has shown that the symptomatic plantar fascia usually measures over 4 mm in thickness.
With ultrasound our podiatrists can also compare the symptomatic heel and plantar fascia thickness to the asymptomatic side, which also helps provide a clearer diagnostic picture. Absence of plantar fascia thickening (less than 4 mm) on ultrasound generally suggests that another factor is likely causing the heel pain.
Correct diagnosis is vital for successful heel pain treatment
Diagnostic ultrasound helps to correctly diagnose the cause of plantar heel pain which is vital for successful treatment. If custom orthotics are required the correct diagnosis also helps formulate the prescription.
For example if a plantar fascia tear is diagnosed then the injury requires support and rest. If the cause is plantar fasciitis then often support and stretching is indicated. Other causes may require footwear changes and orthotics with a specific prescription. For example heel pad atrophy benefits from custom orthotics with a deep heel cup and more cushioned footwear.
Overall since implementing diagnostic ultrasound into our clinic it has lead to a more pinpoint diagnosis of plantar heel pain, leading to greater treatment success.