SWE boosts diagnosis of plantar fasciitis
Shear wave elastography (SWE) improves the diagnostic accuracy in patients with plantar fasciitis (PFis), reported authors of a recent study published in Academic Radiology.
And when SWE is paired with B-mode ultrasound (B-US) its diagnostic accuracy only improved.
“The present study showed for the first time, that SWE has an additive diagnostic value for diagnosing PFis with a sensitivity of 100% for the combined usage of SWE and B-US,” wrote Matthias Gatz, MD, with University Hospital TWTH Aachen’s Department of Orthopedics in Aachen, Germany, and colleagues. “Additionally, the diagnostic accuracy increased from 79% using B-US to 84% using SWE.”
Currently, PFis is diagnosed using B-US to find hypoechoic areas, border irregularities and calcifications. And research shows that plantar fascia thickness of greater than 4 millimeters is the most telling parameter for determining PFis. However, fascia thickness can decrease over time and B-US has been shown to miss fascia patients, the authors noted.
With that in mind, Gatz and colleagues set out to compare B-US and SWE’s ability to analyze fascia stiffness and thickness.
The team divided 82 patients with plantar fascia into three groups: symptomatic (39 patients), control (23) and bilateral asymptomatic (20). Reference standard was defined as a PF thickness greater than 4 mm. They measured the sensitivity, specific and diagnostic accuracy of SWE and B-US and determined the measurements’ correlation to the American Orthopedic Foot and Ankle Score and Food Functional Index.
Overall, SWE proved more sensitive and diagnostically accurate compared to B-mode ultrasound. Specifically, SWE’s sensitivity was 85%, it achieved a specificity of 83% and diagnostic accuracy of 84%. In comparison, the sensitivity, specificity and accuracy of B-US was 61%, 95% and 79%, respectively.
When combined, the method achieved a diagnostic accuracy and sensitivity of 90% and 100%, respectively.
The results, according to the authors, suggest a need to revisit whether B-US should be the go-to for diagnosing PFis.
“SWE provides a quantitative assessment of PF integrity and can distinguish between symptomatic and asymptomatic patients better than B-US,” the researchers concluded. “Therefore, further studies need to reevaluate if B-US is still the gold standard in the diagnosis of PFis.”
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.