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

OBJECTIVE: To determine valuable radiologic criteria in diagnosis of pes cavus. METHOD: Thirty eight healthy subjects and twenty seven pes cavus cases were evaluated by radiologic measurements. We evaluated the criteria for longitudinal arch curve by measuring the calcaneal pitch, talocalcaneal angle, talometatarsal angle, metatarsal angle and navicular height I and II. RESULTS: By comparing the pes cavus with the control group, no significant differences in the talocalcaneal angle, metatarsal angle and navicular height I and II were found. Whereas we found a significant difference between the talometatarsal angle and calcaneal pitch. Talometatarsal angle is more sensitive and specific compared to the calcaneal pitch. CONCLUSION: In diagnosis of idiopathic pes cavus, talometa tarsal angle is more reliable in the diagnosis of pes cavus. The ultimate diagnostic value of talometatarsal angle in pes cavus is 6degrees.
Diagnosis ; Foot Deformities* ; Metatarsal Bones

OBJECTIVE: This study was conducted to compare the effects of low frequency needle transcutaneous electrical nerve stimulation (TENS) and high frequency needle TENS on experimental pain threshold. METHOD: Twenty two healthy adult subjects were assigned randomly to a low-TENS group or to a high-TENS group. Experimental pain threshold at forearm was determined with pain threshold of electrical simulation using surface electrode and needle electrode. RESULTS: Low-TENS group showed that pain relief was developed after 10 minutes and persisted 3 hours after treatment cessation. Low-TENS group showed a significant increase in experimental pain threshold opposing to high TENS group. CONCLUSION: This results suggest that effect of low frequency needle TENS therapy is better and longer than high frequency needle TENS therapy.
Adult* ; Electrodes ; Forearm ; Humans ; Needles* ; Pain Threshold* ; Transcutaneous Electric Nerve Stimulation* ; Withholding Treatment

OBJECTIVE: To evaluate the effect of extracorporeal shock wave therapy (ESWT) in plantar fasciitis with visual analog scale score and thickness of fascia by ultrasonography. METHOD: The subjects consisted of 32 feet (24 patients) with established diagnosis of chronic plantar fasciitis, including 17 feet in the ESWT group and 15 feet in the control group. In the ESWT group, three session of ESWT (0.24 mJ/mm2 FED, 1,200 impulse, weekly) were performed. The visual analog scale (VAS) score and thickness of the plantar fascia were measured by ultrasound before therapy and at the 6-week and 6-month follow-up. Patients in the control group were treated with medication, orthotics, physical therapy and exercise program. VAS and thickness of plantar fascia was evaluated at the same time as ESWT group. RESULTS: In the ESWT group, thickness of plantar fascia decreased significantly at 6-week follow-up (p <0.05) and 6-month follow-up (p <0.05). Control group showed no significant difference at follow-up (>0.05). Visual analog scale score showed no significantly difference at 6-week follow-up (>0.05), but decreased at 6-month follow-up. On the other hand, in the control group, thickness of plantar fascia did not change significantly at 6-week follow-up (>0.05) and 6-month follow-up (>0.05). VAS score was not significant different at the 6-week follow-up (>0.05), but decreased at the 6-month follow-up (p <0.05). CONCLUSION: ESWT in plantar fasciitis is effective in relieving subjective pain and reducing thickness of plantar fascia at 6-month follow-up.
Fascia ; Fasciitis, Plantar ; Follow-Up Studies ; Foot ; Hand ; Humans ; Shock

Patients with ankylosing spondylitis are more susceptible to spine fractures than healthy people. Because of their underlying back pain, vertebral fracture induced pain is not easily controlled by bed rest, physical therapy and medications. Thus, new treatment methods should be introduced. We report a 63 year-old man with ankylosing spondylitis who fell down 4 weeks ago and suffered a fracture of T6 spine. He complained of a mid thoracic pain. Although he was treated with bed rest, physical therapy, second-line bisphosphonate agents, the pain persisted. Therefore, intravenous zoledronate which was approved for palliative treatment of bone metastases in patients with breast cancer, 4 mg was administrated. The severity of pain was decreased by half within 2 days and sustained over 4 weeks.
Back Pain ; Bed Rest ; Breast Neoplasms ; Humans ; Middle Aged ; Neoplasm Metastasis ; Palliative Care ; Spine ; Spondylitis, Ankylosing*

OBJECTIVE: The purpose of this study was to investigate the serum and synovial IGF-I levels in 30 patients with knee osteoarthritis (OA) and the relationships among the IGF-I level, pain intensity and severity of knee OA. METHOD: Thirty patients who met criteria of knee OA of American Rheumatology Association participated in this study. Samples of serum and synovial fluid were obtained from all patients. The levels of IGF-I were determined by radioimmunoassay (RIA). The intensity of pain was assessed by Pain Rating Score (PRS) and Visual Analogue Scale (VAS). The severity of knee OA was evaluated by Kellgren's grade of knee OA. RESULTS: The mean serum and synovial IGF-I level was 231.66+/-86.15 ng/ml and 122.42+/-37.79 ng/ml, respectively. There was no correlation between pain intensity and IGF-I levels. Neither was there statistically significant correlation between Kellgren's grade and IGF-I levels. CONCLUSION: The serum and synovial IGF-I levels were not related with pain intensity and severity of knee OA.
Humans ; Insulin-Like Growth Factor I* ; Knee* ; Osteoarthritis, Knee* ; Radioimmunoassay ; Rheumatology ; Synovial Fluid

OBJECTIVE: To assess the effect of vitamin K2 in addition to risedronate on postmenopausal osteoporosis METHOD: We enrolled 21 postmenopausal osteoporosis women (age: 65.2+/-7.8 years). Ten subjects received risedronate (35 mg, weekly) and vitamin K2 (45 mg, daily) and eleven subjects only received risedronate. They all received calcium citrate 2,130 mg and vitamin D 600 IU daily. The duration of treatment was 7.7+/-1.4 months. Bone mineral density (BMD) of lumbar spine and both femurs, serum osteocalcin and urine deoxypyridinoline were examined at baseline and after treatment. RESULTS: After treatment, BMD, serum osteocalcin and urine deoxypyridinoline were improved in each group but there was no statistical difference between the groups. CONCLUSION: There was no evidence of the benefit of vitamin K2 in addition to risedronate in bone metabolism on postmenopausal osteoporosis.
Bone Density ; Calcium Citrate ; Female ; Femur ; Humans ; Metabolism ; Osteocalcin ; Osteoporosis, Postmenopausal* ; Risedronate Sodium ; Spine ; Vitamin D ; Vitamin K 2* ; Vitamins*

The purpose of this study was to obtain the normative values for variable parameters of lumbar function with the isoinertial triaxial dynamometer in normal subjects and to compare these values with those of the patients with chronic low back pain. In 82 normal subjects and 27 patients with chronic low back pain, the variable parameters including lumbar range of motion (ROM), maximum isometric torques, and maximum isoinertial velocities were measured with the isoinertial triaxial dynamometer in three axes (rotation, flexion-extension, and lateral flexion). In normal subjects, all parameters except lumbar ROM of all three axes were significantly higher in the male group than the female group. However, other anthropometric variables such as age, height, weight, and body mass index were little correlated with each parameter. Therefore, the normative values were obtained only in consideration of the gender. In patients with chronic low back pain, all parameters except the maximum isometric torques in the female group were significantly lower than those in normal subjects. In addition, the decrease of maximum velocities during the isoinertial exercise was highly correlated to verbal rating scales (VRS) in most axes, especially in the female patient group, but the duration of low back pain was little correlated with the various parameters measured with the isoinertial triaxial dynamometer. In conclusion, all parameters measured with the isoinertial triaxial dynamometer in all three axes were significantly lower in patients with chronic low back pain than those in normal subjects except maximum isometric torques of female group. It was suggested that maximum isoinertial velocities were more reliable and significant than maximum isometric torques for the objective assessment of chronic low back pain.
Body Mass Index ; Female ; Humans ; Low Back Pain* ; Male ; Range of Motion, Articular ; Torque ; Weights and Measures

OBJECTIVE: This study was aimed to demonstrate definite diagnostic radiologic criteria between normal and flatfoot. METHOD: Sixty healthy subjects and fifty two flatfoot cases were evaluated by radiologic measurements. We evaluated criteria for longitudinal arch curve by measuring of calcaneal pitch, talocalcaneal angle, talometatarsal angle, metatarsal angle and navicular height I and II. RESULTS: Over 10 years old, there was significant correlation between normal group and flatfoot in calcaneal pitch, talocacaneal angle, difference angle, metatarsal angle, navicular height I and II. But below 10 years old, there was difference in only talometatarsal angle and metatarsal angle. Therefore talometatarsal angle and metartarsal angle are valuable in diagnosis of flatfoot in all age group. CONCLUSION: In diagnosis of flatfoot, variable radiologic measurement are clinically significant.
Child ; Diagnosis ; Flatfoot* ; Humans ; Metatarsal Bones