Ahmet Çağdaş BİÇEN, Utku Mahir YILDIRIM, Meric UNAL

PLANTAR FASİİTTE TOPUK FAT PAD ELASTİKİYETİNİN VE KALINLIĞININ ULTRASON İLE DEĞERLENDİRİLMESİ

Amaç Bu çalışmanın amacı, tek taraflı plantar fasiitli hastalarda topuk yağ yastığının kalınlığını ve elastikiyetini değerlendirmek ve yaş, cinsiyet, vücut kitle indeksi (VKİ) ve fonksiyonel skorların plantar fasiit üzerindeki etkilerini araştırmaktır. Gereç ve Yöntem Çalışmaya 6 aydan uzun süredir tek taraflı plantar fasiiti olan toplam 70 hasta dahil edildi. Hastaların ağrılı ve sağlıklı ayakları arasında ultrason ile yağ yastığının kalınlığı ve elastikiyeti karşılaştırıldı. Elastisite ölçümü için Shear Wave Elastografi (SWE) kullanıldı. Fonksiyonel değerlendirme American Orthopaedic Foot and Ankle Society Skoru (AOFAS) ile yapıldı. Ağrılı ve sağlıklı taraflar arasında kalınlık ve elastikiyet değişkenleri, bağımsız grup t-testi ve Mann-Whitney U testi kullanılarak karşılaştırıldı. Bulgular Hastaların yaş ortalaması 44±11.66 idi. Topuk yağ yastığının ortalama kalınlığı etkilenen tarafta 17.9±3.1 mm ve sağlıklı tarafta 18.3±3.3 mm idi. Ağrılı tarafta ortalama SWE değeri 23.9 m/s (9.3-32), sağlıklı tarafta 24.7 m/s (10.8-34) idi. Hastaların ortalama AOFAS skoru 70 (62-78) idi. Topuk yağ yastığı kalınlığı, sağlıklı ayaklarda ağrılı ayaklara göre daha fazlaydı, ancak bu fark istatistiksel olarak anlamlı değildi (p=0,448). Ağrılı ayaklar daha sertti, ancak fark istatistiksel olarak benzerdi (p=0,347). Ağrılı ve sağlıklı ayaklar arasındaki elastikiyet ve kalınlık değerleri cinsiyetten etkilenmemiştir. VKİ, ağrılı ve sağlıklı ayaklar arasındaki topuk yağ yastığı kalınlığı üzerinde istatistiksel olarak anlamlı bir etkiye sahiptir. Sonuç Topuk yağ yastığı kalınlığındaki azalma plantar fasiit için, VKİ normal olan hastalarda destekleyici bir bulgudur ancak VKİ>25 olan hastalarda destekleyici değildir.

Anahtar Kelimeler:

Plantar fasiit, fat pad, shear wave elastografi, elastisite

EVALUATION OF THE ELASTICITY AND THICKNESS OF THE HEEL FAT PAD WITH ULTRASOUND IN PLANTAR FASCIITIS

Objective The aim of this study was to evaluate thickness and elasticity of heel fat pad in patients with unilateral plantar fasciitis and to investigate the effects of age, sex, body mass index (BMI), and functional scores on plantar fasciitis. Material and Method 70 patients who had been suffering from unilateral plantar fasciitis longer than 6 months were enrolled in the study. The thickness and elasticity of fat pad were compared between the painful and healthy feet of the patients with ultrasound. For measurement of elasticity, shear wave elastography (SWE) was used. Comparative analysis was performed for thickness and elasticity variables between the painful and healthy feet with Mann–Whitney U and independent samples t-test. Results Average of age of the patients was 44±11.66. The average thickness of the heel fat pad was 17.9±3.1 mm on the affected side and 18.3±3.3 mm on the healthy side. The mean SWE value of the painful side was 23.9 m/s (range 9.3-32) and was 24.7 m/s (range 10.8-34) on the healthy side. Heel fat pad thickness was greater in the healthy feet than in the painful feet, but there was no statistical significance (p=0.448). The painful feet were stiffer, but the difference was statistically similar (p=0.347). BMI had a statistically significant impact on thickness of heel fat pad. Conclusion The results showed that a decrease in the heel fat pad thickness was a supporting finding of plantar fasciitis in patients with normal BMI but not in patients with BMI>25.

Keywords:

Plantar fasciitis, fat pad, elasticity, shear wave elastography,

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