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ESWT and Ultrasound

Posted by Pete R on 6/03/02 at 09:02 (086134)

Am I correct in thinking-:

With ESWT the purpose of Ultrasound is to accurately locate (on a screen) the insertion point of the Fascia rather than diagnosing what is actually going on inside the foot (e.g enlarged tendons etc) ?

Can one of the Doc's confirm this. If this is corect presumably the Doc's would only recommend ESWT WITH ultrasound ?

I've had ESWT in the UK WITHOUT ultrasound and was a little sceptical on its accuracy as it was given on the basis of where it hurt most.

Re: ESWT and Ultrasound

Ed Davis on 6/03/02 at 15:16 (086162)

Pete:

I have a diagnostic ultrasound unit in my office and enthusiastically support the use of that modality.

I feel, that in plantar fasciitis, the use of ultrasound is helpful but not a necessity. When I examine the plantar fascia with ultrasound, I know where to look. I use the ultrasound to measure the thickness of the fascia -- hypertrophy of the fascia is a good indicator of how diseased the fascia is.

The ESWT manufacturers are competing for an edge so they will all argue for some distinguishing feature on their unit.

There will be instances in which locating a precise area of pathology can make a difference in treamtment outcomes. I do not feel that it is a critical factor in PF though. Ossatron is applied over a broad area, not necessitating precise aiming. Sonocur is 'aimed' by going after the most painful areas.

The machines disperse their shcok waves over an area that is not necessarily that precise. Few cases of plantar fasciitis are a small target, generally msuch of the plantar fascial insetion is affected. As such the issue of aiming is not really an issue, in my opinion. That will change somewhat with units which have smaller heads such as the Reflectron.

Eventually there will be devices that could be used near nerve trunks (eg TTS) and that would require very precise aiming.
Ed

Re: ESWT and Ultrasound

Ed Davis on 6/03/02 at 15:16 (086162)

Pete:

I have a diagnostic ultrasound unit in my office and enthusiastically support the use of that modality.

I feel, that in plantar fasciitis, the use of ultrasound is helpful but not a necessity. When I examine the plantar fascia with ultrasound, I know where to look. I use the ultrasound to measure the thickness of the fascia -- hypertrophy of the fascia is a good indicator of how diseased the fascia is.

The ESWT manufacturers are competing for an edge so they will all argue for some distinguishing feature on their unit.

There will be instances in which locating a precise area of pathology can make a difference in treamtment outcomes. I do not feel that it is a critical factor in PF though. Ossatron is applied over a broad area, not necessitating precise aiming. Sonocur is 'aimed' by going after the most painful areas.

The machines disperse their shcok waves over an area that is not necessarily that precise. Few cases of plantar fasciitis are a small target, generally msuch of the plantar fascial insetion is affected. As such the issue of aiming is not really an issue, in my opinion. That will change somewhat with units which have smaller heads such as the Reflectron.

Eventually there will be devices that could be used near nerve trunks (eg TTS) and that would require very precise aiming.
Ed