Superb Microvascular Imaging Ultrasonography of Plantar Fasciitis
Condition: Diagnose Disease; Plantar Fasciitis
MeSH terms: Fasciitis; Fasciitis, Plantar
Study type: Observational

Summary: 
      A prospective study will be conducted to evaluate the diagnostic performance of SMI, gray
      scale US, color Doppler US and Power Doppler US.
    

Detailed description: 
      Plantar fasciitis (PF) is a painful condition of the inferior and medial heel. Symptoms
      worsens with the first steps in the morning or after prolonged sitting and long periods of
      standing.

      The diagnosis of PF is made according to the typical anamnesis and physical examination,
      based on the emerge of local point tenderness over the heel and proximal fascia due to the
      pressure applied by the physician. Heel pain exacerbates by the first steps in the morning or
      after rest and with prolonged standing. Unless there is an inflammatory disease such as
      spondyloarthropathy, there is no laboratory finding indicating plantar fasciitis. Imaging
      methods are very useful for making an accurate diagnosis. Because the main problem is in the
      soft tissue, plain radiography has limited diagnostic value, but can be helpful in
      identifying calcaneal stress fractures.

      Magnetic resonance imaging (MRI) is very successful in showing the inflammatory process of
      soft tissue. However, it does not seem possible to use MRI scans routinely because of the
      cost and time it requires.

      PF can be evaluated with ultrasonography with the advantages of being non-invasive,
      relatively inexpensive, easy to access and apply, and is increasingly used in clinical
      practice. Color Doppler evaluation is a very valuable part of musculoskeletal sonographic
      examination and facilitates the clinician's decision as an inflammation marker. Power Doppler
      US is quite sensitive to tissue or probe movement, especially at low pulsed repetition
      frequency (PRF). Flash artifacts may be observed. However, Doppler USG has limited
      sensitivity at low flows and small vessel structures.

      Superb microvascular imaging (SMI) (Toshiba Medical Systems, Tokyo, Japan) is a new mode of
      vascular imaging that provides visualization of activity in microvascular structures or in
      structures that have low flow rate.

      To the best of our knowledge, there are no studies comparing the diagnostic performance of
      the SMI modality in plantar fasciitis with color Doppler and gray scale US. Therefore, a
      prospective study will be conducted to evaluate the diagnostic performance of SMI, gray scale
      US, color Doppler US and Power Doppler US. The null hypothesis that there is no difference
      between Doppler US and SMI methods in the detection of increased inflammatory activity in
      plantar fasciitis patients.
    

Intervention name(s): Superb Microvascular Imaging (SMI) (Toshiba)
Intervention type(s): Device
Intervention description(s): to determine whether there is a diagnostic value of SMI in Plantar Fasciitis and whether there is a superiority when compared Power Doppler and Color Doppler modalities.
Observational model: Case-Control
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        -  Patients who diagnosed as Plantar Fasciitis as the first group

          -  Healthy participants as the second group
      
Keywords: superb microvascular imaging; diagnose; microvascularization; plantar fasciitis