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Diagnostic Ultrasound

Posted by Elyse B on 7/06/04 at 10:54 (154606)

Have either of the doctors heard about using diagnostic ultrasound to see whether one has PF or if it is nerve issue? A 'reknowned' podiatrist in NYC has suggested that test and I never heard of it. He says that my feet look 'too good' to have PF from my x-rays. I guess he was able to tell in the 5 minutes he examined me and NOT watching me walk.

Re: Diagnostic Ultrasound

Dr. Z on 7/06/04 at 11:59 (154610)

Hi

I have been using diagnostic ultrasound for years. One of the best if not the best type of evaluation for plantar fasciitis

Re: Diagnostic Ultrasound

Elyse B on 7/06/04 at 12:24 (154612)

Thanks Dr. Z. Was wondering why the three podiatrists I went to never did it. Can it tell if you have PF or whether it is a nerve issue. Do you do it in your office as one podiatrist I went to is sending me to a hospital to get it done.

Re: Diagnostic Ultrasound

Dr. Z on 7/06/04 at 12:46 (154615)

I do it in my office. It will tell if you have plantar fasciitis without a doubt. Since I do alot of ESWT and see alot more cases then the average physician we have the machine in our office. The resolution and quality is amazing. We can even see the area in three dimensional views with our new machine.

Re: Diagnostic Ultrasound

Elyse B on 7/06/04 at 13:13 (154617)

wow that is great, thanks.

Re: Diagnostic Ultrasound

Elyse B on 7/06/04 at 13:53 (154623)

do you do doppler imaging which is a new form of ultrasonic blood flow detection method? That seems to be what my podiatrist wants me to get.

Re: Diagnostic Ultrasound

Ed Davis, DPM on 7/07/04 at 09:36 (154722)

Elyse:
Diagnostic ultrasound, in PF, is used to look at the thickness of the fascia and to some extent, it consistency, to see if the tissue looks diseased. I, too, am using more often for PF as x-rays are very limited in the information it can provide about PF which is a soft tissue problem.
Ed

Re: Diagnostic Ultrasound better than MRI?

John Martello on 7/07/04 at 18:31 (154801)

I had an MRI of tendon pathology and was wondfering if dignostic ultrasound can provide better picture quality than MRI?

Re: Diagnostic Ultrasound better than MRI?

Ed Davis, DPM on 7/07/04 at 23:49 (154824)

John:
It can be a hard call, at times. MRI has the advantage of different types of images while ultrasound has the advantage of observing a tendon in motion. Ultrasound is less expensive and used more frequently and in 'real time.'
Ed

Re: Diagnostic Ultrasound

MarkF on 11/20/07 at 19:17 (239692)

I was diagnosed with Plantar Fasciitis in April of 2007. I am having the diagnostic ultrasound on Monday to determine whether I would be a candidate for ESWT or the topaz procedure. I want to save the EPF as the last option. What does the podiatrist need to see on the ultrasound in order for me to be a candidate for these procedures? I have been told that the fascia needs to be in a degenerative state (chronic) for these procedures to be an option. What if the patient is not in a degenerative state? Would ESWT or the topaz procedure still be an option? If you have any thoughts on this topic please post some advice. I have tried every conservative treatment possible: physical therapy, ultrasound and iontophoresis, ice message, night splint, 3 cortisone shots, stretching routines, cam walker for one month, plenty of anti-inflammatories, Medrol pack, etc.

Re: Diagnostic Ultrasound

Dr. Ed on 11/20/07 at 19:41 (239697)

Mark:

You did not list orthotics as a conservative treatment.

ESWT and Topaz have minimal or no effect on plantar fasciitis so if that is what is shown on ultrasound those procedures should not be considered. ESWT and Topaz are procedures for plantar fasciosis.

Dr. Ed

Re: Diagnostic Ultrasound

MarkF on 11/20/07 at 20:46 (239698)

Dr. Ed,

Yes, I forgot to mention the orthotics. I have several pairs. In fact, I have the pinnacle powerstep, but they tend to aggravate the small bone spur in my left heel. I also have a custom made pair ($350.00), but they are rigid and my feet actually hurt worse when I have them inserted. I think I'm actually a candidate for the EPF because my heel tendon is tight. However, on the pain threshold......I'm about a 2 on a scale of 10.

Re: Diagnostic Ultrasound

Dr. Ed on 11/21/07 at 07:48 (239713)

'I think I'm actually a candidate for the EPF because my heel tendon is tight.'

A tight heel (achilles) tendon has nothing to do with the need for EPF.
A tight achilles can make a number of treatments for PF fail and need be addressed. Some options are: night splint, manual therapy and, if the first two fail then achilles tendon lengthening or gastroc. recession.

Dr. Ed

Re: Diagnostic Ultrasound

MarkF on 11/23/07 at 09:07 (239771)

Dr. Ed,

Please allow me to clarify my previous post. When I said my heel tendon was tight, I was referring to my plantar fascia and NOT the achilles tendon. I am having the diagnostic ultrasound on Monday. Hopefully, I will be able to report back which treatment options are available for me.