Radiological Evaluation of the Relationship Between Plantar Fasciitis and Foot Arch Angles in Adults

Year 2023, , 31 - 40, 28.02.2023

Mehmet Boz Abdullah Alper Şahin , Mehmet Akçiçek

https://doi.org/10.19127/mbsjohs.1183351

Abstract

Objective: The foot arch deformation increases plantar fasciitis (PF) and plantar calcaneal spur (PCS) for-mation. As a result, the heel fat pad becomes thinner. This study investigated the relationship between plantar fasciitis and foot arch angles.

Methods: We performed a retrospective review of patients who had PF patients (n = 53) and healthy individu-als (n = 71) without PF. We have evaluated the presence of PCS and heel fat pad thickness measurements on magnetic resonance imaging (MRI), and the lateral talus-first metatarsal angle (Meary’s angle), lateral talocal-caneal angle, and calcaneal inclination angle measurements were performed on X-ray images.

Results: The mean age of the PF group was significantly higher than the control group (p = 0.001). The degrees of Meary’s angle and calcaneus inclination angle were significantly higher in the PF group (p < 0.001 and p = 0.026, respectively) than in the control group. The incidence of PCS was significantly higher in the PF group (p = 0.028). In the binary logistic regression analysis model, high Meary’s angle and calcaneal pitch angle were found to be associated with the risk of PF. There was also a significant association between age and the pres-ence of PCS and PF.

Conclusion: Changes in Meary’s angle and calcaneal pitch angle were significant risk factors for PF.

Keywords

Plantar fasciitis, heel fat pad, calcaneal spur, Meary, lateral talo-calcaneal angle, calcaneal inclination angle

References

• 1. Huang YP, Peng HT, Wang X, Chen ZR, Song CY. The arch support insoles show benefits to people with flatfoot on stance time, cadence, plantar pressure and con-tact area. PLoS One 2020;15:e0237382.
• 2. Shin SH, Lee HK, Kwon MS. Correlation between lower extremities joint moment and joint angle according to the different walking speeds. Korean J Sport Biomech 2008;18: 75-83.
• 3. Park SY, Bang HS, Park DJ. Potential for foot dysfunction and plantar fasciitis ac-cording to the shape of the foot arch in young adults. J Exerc Rehabil 2018;14:497-502.
• 4. Singh D, Angel J, Bentley G, Trevino SG. Fortnightly review. Plantar fasciitis. BMJ 1997;315:172-175.
• 5. Buchbinder R. Clinical practice. Plantar fasciitis. N Engl J Med 2004;350:2159-2166.
• 6. Goff JD, Crawford R. Diagnosis and treatment of plantar fasciitis. Am Fam Physician 2011;84:676-682.
• 7. Lo HC, Chu WC, Wu WK, Hsieh H, Chou CP, Sun SE, et al. Comparison of radio-logical measures for diagnosing flat-foot. Acta Radiol 2012;53:192-196.
• 8. Houglum PA, Bertoti DB. Brunnstrom’s clinical kinesiology. 6th ed. Phil¬adelphia (PA): The F.A Davis Co.; 2012.
• 9. Karabay N, Toros T, Hurel C. Ultraso-nographic evaluation in plantar fasciit-is. J Foot Ankle Surg 2007;46:442-446.
• 10. Thomas JL, Christensen JC, Kravitz SR, Mendicino RW, Schuberth JM, Va-nore JV, et al. The diagnosis and treat-ment of heel pain: a clinical practice guideline-revision 2010. J Foot Ankle Surg 2010;49:S1-S19.
• 11. Huang YC, Wang LY, Wang HC, Chang KL, Leong CP. The relationship between the flexible flatfoot and plantar fasciitis: ultrasonographic evalua-tion. Chang Gung Med J 2004;27:443-448.
• 12. Flores DV, Mejía Gómez C, Fernández Hernando M, Davis MA, Path-ria MN. Adult acquired flatfoot deformi-ty: Anatomy, biomechanics, staging, and imaging findings. Radiographics 2019;39:1437-1460.
• 13. Jeswani T, Morlese J, McNally EG. Getting to the heel of the problem: plan-tar fascia lesions. Clin Radiol 2009;64:931-939.
• 14. Cutts S, Obi N, Pasapula C, Chan W. Plantar fasciitis. Ann R Coll Surg Engl 2012;94:539-542.
• 15. Frey C, Zamora J. The effects of obesity on orthopaedic foot and ankle pa-thology. Foot Ankle Int 2007;28:996-999.
• 16. Abate M, Schiavone C, Di Carlo L, Salini V. Achilles tendon and plantar fas-cia in recently diagnosed type II diabetes: role of body mass index. Clin Rheumatol 2012;31:1109-1113.
• 17. Caliskan E, Koparal SS, Igdir V, Alp E, Dogan O. Ultrasonography and eryth-rocyte distribution width in patients with plantar fasciitis. Foot Ankle Surg 2021;27:457-462.
• 18. Rome K, Howe T, Haslock I. Risk factors associated with the development of plantar heel pain in athletes. The foot 2001;11:119-125.
• 19. Rano JA, Fallat LM, Savoy-Moore RT. Correlation of heel pain with body mass index and other characteristics of heel pain. J Foot Ankle Surg 2001;40:351-356.
• 20. Wearing SC, Smeathers JE, Yates B, Sullivan PM, Urry SR, Dubois P. Sagittal movement of the medial longitudinal arch is unchanged in plantar fasciit-is. Med Sci Sports Exerc 2004;36:1761-1767.
• 21. Pasapula C, Kiliyanpilakkil B, Khan DZ, Di Marco Barros R, Kim S, Ali AME, et al. Plantar fasciitis: Talonavicu-lar instability/spring ligament failure as the driving force behind its histological pathogenesis. Foot (Edinb) 2021;46:101703.
• 22. Johal KS, Milner SA. Plantar fasciit-is and the calcaneal spur: Fact or fic-tion?. Foot Ankle Surg 2012;18:39-41.
• 23. Beytemür O, Öncü M. The age de-pendent change in the incidence of calca-neal spur. Acta Orthop Traumatol Turc 2018;52:367-371.
• 24. Jahss MH, Michelson JD, Desai P, Kaye R, Kummer F, Buschman W, et al. Investigations into the fat pads of the sole of the foot: anatomy and histology. Foot Ankle 1992;13:233-242.
• 25. Belhan O, Kaya M, Gurger M. The thickness of heel fat-pad in patients with plantar fasciitis. Acta Orthop Traumatol Turc 2019;53:463-467.
• 26. Hsu TC, Wang CL, Tsai WC, Kuo JK, Tang FT. Comparison of the mechan-ical properties of the heel pad between young and elderly adults. Arch Phys Med Rehabil 1998;79:1101-1104.
• 27. Huang CK, Kitaoka HB, An KN, Chao EY. Biomechanical evaluation of longitudinal arch stability. Foot Ankle 1993;14:353-357.
• 28. Taunton JE, Ryan MB, Clement DB, McKenzie DC, Lloyd-Smith DR, Zumbo BD. A retrospective case-control analysis of 2002 running injuries. Br J Sports Med 2002;36:95-101.
• 29. Menz HB, Zammit GV, Landorf KB, Munteanu SE. Plantar calcaneal spurs in older people: longitudinal traction or ver-tical compression?. J Foot Ankle Res 2008;1:7.