肌肉骨骼超声检查对慢性足底筋膜炎的诊断价值

Diagnostic value of musculoskeletal ultrasonography in chronic plantar fasciitis

目的探讨肌肉骨骼超声检查对慢性足底筋膜炎的诊断价值,为超声检查诊断慢性足底筋膜炎提供依据。方法选取2014年1月至2016年12月期间青海省中医院收治的慢性足底筋膜炎患者46例为研究对象。采用肌肉骨骼超声测量两次所纳入患者健侧和患侧足底筋膜的厚度,两次超声检查间隔2 d,采用组内相关系数(ICC)验证两次超声检查的重复性测量信度。比较健侧和患侧的ICC,同时对比两次足底筋膜厚度的测量结果。结果患侧两次超声检查结果的ICC值为0.83,健侧两次超声检查结果的ICC值为0.91,双侧超声检查结果的ICC值比较差异无统计学意义(P>0.05);患侧足底筋膜厚度第1次测量结果为(4.88±0.28)mm,第2次测量结果为(5.63±0.25)mm,两次平均测量结果为(5.26±0.18)mm,均明显大于健侧足底筋膜厚度[分别为(3.79±0.21)mm、(3.97±0.21)mm、(3.88±0.25)mm],差异均有统计学意义(P<0.05)。结论肌肉骨骼超声检查可较准确地测量慢性足底筋膜炎患者的足底筋膜厚度,评估足底筋膜炎症水肿的严重程度,可为慢性足底筋膜炎的临床诊断提供参考依据。

Objective To investigate the diagnostic value of musculoskeletal ultrasound in chronic plantar fas-ciitis, and to provide the basis for the diagnosis of chronic plantar fasciitis by ultrasonography. Methods A total of 46 patients with chronic plantar fasciitis, who treated in our hospital from January 2014 to December 2016, were selected as the subjects. The thickness of the plantar fascia of the uninjured side and the affected side were measured two times by musculoskeletal ultrasound. The two-ultrasound interval was 2 days. The intraclass correlation coefficient （ICC） was used to verify the reproducibility of the two ultrasonographic measurements. The ICCs of the uninjured side and the affected side were compared. Meantime, the measurements of the plantar fascia thickness of two times were also compared. Results The ICC value of the two ultrasonographic measurements of the affected side was 0.83, versus 0.91 for the uninjured side （P〉0.05）;The thickness of the plantar fascia of the affected side was （4.88±0.28） mm in the first measurement and （5.63±0.25） mm in the second measurement, with the mean of （5.26±0.18） mm, which were sig-nificantly larger than the corresponding （3.79±0.21） mm, （3.97±0.21） mm, （3.88±0.25） of the uninjured side （P〈0.05）. Conclusion Musculoskeletal ultrasonography can accurately measure the plantar fascia thickness of patients with chronic plantar fasciitis, which can be used to assess the severity of edema and provides reference for the clinical diagno-sis of chronic plantar fasciitis.