探讨超声在足底跖筋膜炎诊断中的应用价值  

Applied value of ultrasonography in diagnosis of plantar fasciitis

作　　者：周亚静[1] 徐宁 荣雪余[1] 赵汉学[1] 魏芳远[2] ZHOU Ya-jing;XU Ning;RONG Xue-yu;ZHAO Han-xue;WEI Fang-yuan(Ultrasound Department,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China;Foot and Ankle Surgery Center,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院超声诊断科,北京100730 [2]首都医科大学附属北京同仁医院足踝外科中心,北京100730

出　　处：《骨科》2020年第5期362-366,共5页ORTHOPAEDICS

摘　　要：目的探讨超声在足底跖筋膜炎诊断及鉴别中的应用价值。方法回顾性分析2019年1月至2020年7月,我院203例临床诊断跟痛症病人的临床及超声影像学资料,并总结病因。对比分析跖筋膜炎病人的双侧跖筋膜及足底脂肪垫的超声参数。按身体质量指数(body mass index,BMI)是否大于24 kg/m^2分为BMI>24 kg/m2组和BMI≤24 kg/m^2组,对比两组上述参数,探讨超声诊断跖筋膜炎的价值。结果跖筋膜炎是203例病人足跟痛的首要病因,占82.8%。其中跖筋膜炎病人患侧跖筋膜跟骨止点处的超声测量厚度大于健侧(0.50 cm vs.0.37 cm),而脂肪垫厚度小于健侧(0.55 cm vs.0.60 cm),差异均有统计学意义(P均<0.05),中段跖筋膜厚度的差异无统计学意义(P>0.05)。BMI>24 kg/m^2组与BMI≤24 kg/m^2组病人右侧跟骨止点处跖筋膜厚度的差异无统计学意义(P>0.05),而BMI>24 kg/m^2组左侧跖筋膜厚于BMI≤24 kg/m^2组(0.46 cm vs.0.40 cm),差异有统计学意义(P<0.05)。同时,BMI>24 kg/m^2组右侧足底脂肪垫厚度较BMI≤24 kg/m^2组增厚(0.59 cm vs.0.50 cm),差异有统计学意义(P<0.05)。结论超声可直接显示跖筋膜跟骨止点处增厚,可为足底跖筋膜炎临床诊断提供定量的参数指标,对于足跟痛的软组织因素分析和鉴别有重要临床价值。Objective To explore the applied value of ultrasonography in the diagnosis and differentiation of plantar fasciitis.Methods A total of 203 cases of heel pain clinically diagnosed from January 2019 to July 2020 were enrolled into this study.The clinical and ultrasound imaging data of different etiology of heel pain were retrospectively studied.Bilateral fat and plantar ultrasonic parameters of patients with plantar fasciitis were analyzed.According to body mass index(BMI),these patients were divided into BMI>24 kg/m^2 and BMI≤24 kg/m^2 groups,and then the above parameters were compared between groups.Results The plantar fasciitis was the primary cause of the heel pain,and accounted for 82.8%.Among plantar fasciitis cases,the thickness of the proximal affected plantar fascia was greater than the healthy side(0.50 cm vs.0.37 cm),and the thickness of the proximal affected fat pad was smaller than the healthy side(0.55 cm vs.0.60 cm)(P<0.05).The thickness of the middle affected plantar fascia had no significant difference between bilateral sides(P>0.05).The thickness of the proximal plantar fascia in the BMI>24 kg/m^2 group was greater than that in the BMI≤24 kg/m^2 group on the left side(0.46 cm vs.0.40 cm)(P<0.05),and there was no significant difference on the right side.The thickness of fat pad in the BMI>24 kg/m^2 group was greater than that in the BMI≤24 kg/m^2 group on the right side(0.59 cm vs.0.50 cm)(P<0.05).Conclusion The changes of plantar fascia thickness directly shown by ultrasound can provide quantitative parameters for clinical practice and had a potential value in differential diagnosis of heel pain.

关 键 词：足跟痛 跖筋膜炎 超声 鉴别 

分 类 号：R445.1[医药卫生—影像医学与核医学] R686.1[医药卫生—诊断学]