PURPOSE: To evaluate the sonographic findings of plantar fasciitis. MATERIALS AND METHODS: Both feet of 30patients(mean age, 44years) in whom plantar fasciitis had been clinically diagnosed, and those of healthyvolunteers(mean age, 34years) were evaluated with ultrasound(US) using a 7.0MHz linear array transducer. Heel painwas unilateral in 26 patients and bilateral in four. Sagittal sonograms were obtained in the prone position, andthe thickness of the plantar fascia was measured at its proximal end near its insertion into the calcaneus. Wealso evaluated hypoechoic fascia, perifascial fluid collection, fiber rupture, calcaneal spur and calcifications. RESULTS: Plantar fascia thickness was significantly greater in the heels of patients with plantarfasciitis(3.2-8mm; mean, 5.1 +/-1.12) than in their asymptomatic heels(1.3-5mm; mean, 3.5 +/-0.78)(p<0.0001), inwhich it was similar to that of heels of patients in the control group(1.8-5mm; mean, 3.0 +/-0.71)(p<0.0001). Theproximal plantar fascia was hypoechoic in 31 symptomatic heels(91.2%), in four asymptomatic heels(15.4%), and innone of the patients in the control group. Calcaneal spurs were identified in sixteen symptomatic heels(47.1%),and in two which were asymptomatic(7.7%). Perifascial fluid collection was identified in only two symptomaticheels(5.9%). CONCLUSION: In plantar fasciitis, sonography demonstrates that the fascia is thicker as well ashypoechic. For the clinical diagnosis of planter fasciitis, US can therefore be used as an adjunct to clinicaldiagnosis.
Calcaneus ; Diagnosis ; Fascia ; Fasciitis ; Fasciitis, Plantar* ; Foot ; Heel ; Heel Spur ; Humans ; Prone Position ; Rupture ; Transducers ; Ultrasonography*

The objective of this study is to determine the effectiveness of 16-month milk consumption as a part of the health promotion community program for women in Asan. Subjects included 313 women belonging to the milk group (mean age = 69.1, range 47~89 y) and 66 women to the control (mean age = 43.6, range 20~69 y) group. For those in the milk group, one cup (200ml) of partially lactose-digested low-fat milk was provided everyday for 16 months. Each subject was interviewed to assess calcium intake by a 24-h recall after fasting blood was obtained for analyzing bone turnover markers, and calcaneus broadband ultrasound attenuation (BUA) was measured by quantitative ultrasound (QUS) on the left heel before and after the milk supplementation. After 16 months, the calcium intake levels changed from 55% of recommended dietary allowance (RDA) to 85% RDA in the milk group and from 73% RDA to 84% RDA in the control group. BUA were reduced from 67.9+/-8.1 to 64.7+/-17.5 dB/MHz for milk and from 90.4+/-13.0 to 87.2+/-15.2 dB/MHz for control groups. Paired ttest showed the changes of BUA for both groups (-3.24 and -3.15 dB/MHz for milk and control groups, respectively) were significant, but the two groups did not show any differences in absolute changes. When post-BUA was analyzed after age, initial BUA and menopausal status were controlled as covariates in ANCOVA model, the milk group showed significantly (p < 0.05) smaller changes than the control group (-3.50 vs -6.71 dB/MHz, respectively). According to a multiple regression analysis, milk consumption and initial BUA showed significant interaction meaning that those with lower initial BUA showed higher milk effects. We conclude that one-cup a day milk consumption for 16 month can prevent further bone loss and significantly improve calcium intake.
Calcaneus ; Calcium ; Chungcheongnam-do* ; Fasting ; Female ; Health Promotion ; Heel ; Humans ; Milk* ; Osteocalcin ; Recommended Dietary Allowances ; Ultrasonography*

The purpose of this study was to investigate the relation between bone mineral density and nutrient intake among normal and obese elementary students. Each subject was assigned to one of such as normal (n = 69) and obese groups (n = 94) according to their obesity indices. And they were asked for general characteristics, dietary habits and nutrient intakes using questionnaires and 24-hr recall method. They measured the sound of speed (SOS) of calcaneus using quantitative ultrasound. The averages age of the subjects were 10.6 years in normal and 10.7 years in obese group. The averages weight (p < 0.001) and obesity index (p < 0.001) of the normal group were significantly lower than those of the obese group. In dietary habits, the obese group in boys was the higher skipped breakfast than normal group (p < 0.01). The plant calcium intake of obesity in girls was lower than those of normal group (p < 0.05). The SOS in the calcaneus was 1697.6 m/s in the obese group and 1763.7 m/s in the normal group (p < 0.01). The SOS in the calcaneus was negatively correlated to weight (p < 0.01), obesity index (p < 0.001) and percent of body fat (p < 0.01). Also the SOS in the calcaneus was positively correlated plant calcium intake (p < 0.05). In conclusion, the excessive increase of weight and percent of body fat in elementary students appeared to have negative impact to bone health. And based on these results, further studies on the effects on bone mineral density of obese and nutrient intakes in needed for proper bone health.
Adipose Tissue ; Bone Density* ; Breakfast ; Calcaneus ; Calcium ; Female ; Food Habits* ; Humans ; Obesity ; Plants ; Ultrasonography ; Surveys and Questionnaires

OBJECTIVE: To evaluate the effects of age, height, weight, body mass index (BMI), diabetes mellitus, osteoporosis, smoking and alcohol on postural sway (PS) and limb load asymmetry (LLA) in the rural inhabitants in Korea METHOD: Nine hundred and sixty inhabitants were included in this study. PS and LLA were recorded while the subjects were standing on two adjacent force platforms (Mediance(R); Human-Tech Inc, Korea) in a comfortable stance for 30 seconds. Bone mineral density was measured in the right calcaneus by ultrasonography (Sahara(R); Hologic Inc, USA). History of diabetes and smoking were taken through interview. RESULTS: PS and LLA were correlated with age (p<0.01). There were significant decreases in PS and LLA in the young age-group (p<0.01). There was no significant difference in PS and LLA in terms of sex, osteoporosis, height, weight, BMI and smoking. There was a significant difference in LLA (p<0.05) but no difference in PS between diabetic and normal groups. CONCLUSION: PS and LLA may be related with ageing. Diabetic group may have higher LLA than normal group. However, sex, osteoporosis, height, weight, BMI, and smoking may not affect on PS and LLA.
Body Weight ; Bone Density ; Calcaneus ; Diabetes Mellitus ; Extremities* ; Korea* ; Osteoporosis ; Smoke ; Smoking ; Ultrasonography

OBJECTIVES: The aim of this study was to investigate prevalence of osteoporosis and its related factors in women farm workers. METHODS: The present study is a cross-sectional study. The study population consisted of 94 women farm workers aged 38 years and older with BMD measurements using quantitative ultrasound at calcaneus. Prevalence of osteoporosis and its related risk factors were analyzed. RESULTS: Prevalence of osteoporosis in women farm workers (range of age, 38~83 year-old; average age, 61.3 year-old) was 40.4% at calcaneus. Risk of osteoporosis was significantly increased with age; 60~69 year-old (OR, 18.50; 95% CI, 3.55~96.34) and > or =70 year-old (OR, 57.81; 95% CI, 11.32~295.20). After adjusting for age, risk of osteoporosis was significantly associated with annual household income below 20,000,000 Won (OR, 9.86; 95% CI, 1.03~94.34) and overweight (BMI, 23.0~24.9 kg/m2) (OR, 0.18; 95% CI, 0.05~0.72). CONCLUSIONS: Prevalence of osteoporosis in women farm workers was high and risk of osteoporosis was significantly associated with age, household income and BMI.
Calcaneus ; Cross-Sectional Studies ; Family Characteristics ; Female ; Humans ; Osteoporosis ; Overweight ; Prevalence ; Risk Factors ; Ultrasonography

The objective of this study is to determine the effectiveness of 4-month milk consumption in the prevention of osteoporosis in elderly women living in Asan. Subjects included 277 women age over 65 years were divided into control (n=111) and milk (n=166) groups. For those in the milk group, one cup (200ml) of partially lactose-digested low-fat milk was provided everyday for 4 months. Each subject was interviewed to assess food intake by 24-h recall method before and after milk supplementation. Prevalence of osteoporosis was determined by WHO criteria with calcaneus bone mineral density (BMD) measured by quantitative ultrasound (QUS) on left heel. After 4 months, the nutrient intake levels of control did not change while intakes of energy, protein, calcium, phosphorous, riboflavin, pyridoxin, niacin and folic acid were significantly increased in milk group. No significant changes were observed in anthropometric, and BMD in both control and milk groups. T-score of milk group, however, was significantly increased after 4 month milk consumption. Prevalence of osteoporosis was increased (27% to 32%) in control group while that of milk group was decreased (32% to 30%). When BMD and t-score changes after 4 months of milk consumption were compared between those with low baseline calcium intake and high calcium intake subjects in the milk group, BMD and t-score were significantly improved in the low baseline calcium intake group. We conclude that one cup a day milk consumption for a relatively short period of 4 months can prevent further bone loss and significantly improve intakes of both macro and micro-nutrients of elderly women.
Aged* ; Bone Density* ; Calcaneus ; Calcium* ; Chungcheongnam-do* ; Eating ; Female ; Folic Acid ; Heel ; Humans ; Milk* ; Niacin ; Osteoporosis ; Prevalence ; Pyridoxine ; Riboflavin ; Ultrasonography

OBJECTIVE: To know the clinically meaningful findings of ultrasonography in plantar fasciitis. METHOD: Thirty one feet of 24 patients who had clinical diagnosis of plantar fasciitis and 70 feet of 35 healthy volunteers were evaluated with ultrasound. Sagittal sonograms were obtained in the prone position, and the plantar fascia thickness (PFT) was measured at proximal end near its insertion into the calcaneus. Hypoechogenecity, perifascial fluid collection, tendon rupture, calcaneal spur and calcification were also evaluated. RESULTS: The plantar fascia thickness (PFT) of the symptomatic heels (SH) of patients group (4.83+/-0.86 mm) was significantly greater than that of their asymtomatic heels (ASH) (2.95+/-0.57 mm)(p<0.05) and it was also greater than that of control group (2.63+/-0.41 mm)(p<0.05). The range of difference of both PFT was 0.7~3.2 mm in patients group and 0~0.8 mm in control group. Hypoechogenecity was found in 22 SH (71%), perifascial fluid collection in 5 SH (16%) and calcification in 2 SH (6%). Calcaneal bony spur was identified in 7 SH (26%) on simple radiography. CONCLUSION: Increased thickness (>3.8 mm), difference of thickness between SH and ASH (>1.0 mm) and hypoecho genecity of plantar fascia were clinically meaningful ultrasonographic findings of plantar fasciitis, and ultrasonogrphy can be used as the inital imaging modality for the diagnosis.
Calcaneus ; Diagnosis ; Fascia ; Fasciitis, Plantar* ; Foot ; Healthy Volunteers ; Heel ; Heel Spur ; Humans ; Prone Position ; Radiography ; Rupture ; Tendons ; Ultrasonography

Mycetoma is a chronic, debilitating, granulomatous disease affecting the subcutaneous tissue, fascia, muscle, bone and adjacent organs characterized by triad of tumefaction, draining sinus, and grains. The ten-year incidence in our institution from 2000 to 2010 is 3 out of 81,015 cases. We present a 33-year-old man with a nine-year history of painless nodules and draining sinuses on the left foot which were unresponsive to oral antibiotics and topical antifungals. Biopsy of a nodule was consistent with mycetoma. Fungal culture revealed Madurella mycetomatis growth confirming eumycetoma. X-ray of the left foot showed poorly marginated lucencies on the calcaneus and navicular bones. Ultrasound revealed mixed hyperreflective echoes and multiple small cavities. We diagnosed the patient with Stage III eumycetoma based on the radiographic classification of bone involvement and prescribed oral ketoconazole 400 mg daily for nine months achieving 50-60% decrease in lesion size. Surgical debulking was done and ketoconazole was continued at the same dose for another nine months. There was good granulation tissue formation and no appearance of new lesions after surgery.

Human ; Adult ; Anti-bacterial Agents ; Calcaneus ; Cytoreduction Surgical Procedures ; Fascia ; Foot ; Granulation Tissue ; Ketoconazole ; Madurella ; Mycetoma ; Subcutaneous Tissue ; Ultrasonography

OBJECTIVE: This study is designed to evaluate the relationship between bone mineral density (BMD) and life-style factors such as physical activity, smoking, and alcohol consumption and to offer the information for the modification of life-style. METHOD: Eight hundred and sixty nine inhabitants (354 males and 515 females whose age was 55.0+/-13.9 years- old) were participated in this study. BMD was measured in the right calcaneus by quantitative ultrasound (Mark 6000(R), Medison). Amount of physical activity, smoking, and alcohol consumption were got through the closely designed interview. Independent sample T-test and simple regression were used for data analysis. RESULTS: Amount of physical activities were 2656.8+/-732.3 cal/day, smokers were 329 persons (37.9% of inhabitants), and amount of alcohol consumption were 26.2+/-53.3 g/day. Increasing the amount of physical activity, BMD showed significantly higher T-score (p<0.01). Increasing the amount of alcohol consumption, BMD showed significantly lower T-score (p<0.01). BMD in smokers appeared significantly lower T-score than non-smokers (p<0.01). CONCLUSION: Life-style factors significantly effect on bone mineral density. Therefore prevention of osteoporosis through maintenance or augmentation of BMD needs proper physical activity, cessation of smoking, and no heavy drinking.
Alcohol Drinking ; Bone Density* ; Calcaneus ; Drinking ; Female ; Humans ; Male ; Motor Activity ; Osteoporosis ; Smoke ; Smoking ; Statistics as Topic ; Ultrasonography

The aim of this study was to establish reference data for the quantitative ultrasound (QUS) of the calcaneus and for the bone mineral densities (BMD) of the calcaneus and distal forearm, and to evaluate the correlation between QUS parameters and BMD in a Korean population. We performed a cross-sectional study involving 3,053 subjects (1,225 men and 1,828 women). QUS was conducted on the calcaneus and was quantified as speed of sound (SOS, m/sec), broadband ultrasound attenuation (BUA, dB/MHz), and stiffness index. The BMD of the calcaneus and distal forearm were measured using dual X-ray absorptiometry. The peak mean values for the QUS parameters occurred in the 20 to 29-yr-old subjects of both sexes, with the exception of the BUA, which reached the highest values in women of 30-39 yr. For both sexes, the mean BMD of the calcaneus was highest in those 20-29 yr old and that of the distal forearm was highest in those 40-49 yr old. The correlations between the QUS and BMD results were found to be 0.41 to 0.73 in men and 0.51 to 0.76 in women. Theses data can serve as a reference values for both sexes in Korea.
Adult ; Aged ; *Bone Density ; Calcaneus/*metabolism/*ultrasonography ; Cross-Sectional Studies ; Densitometry, X-Ray ; Female ; Forearm ; Humans ; Korea ; Male ; Middle Aged ; Osteoporosis/etiology/metabolism/ultrasonography ; Reference Values ; Risk Factors