The value of ultrasound in the evaluation of the type 2 diabetes mellitus related plantar fascia changes

Abstract

Background

Plantar fasciopathy is a common complication in diabetes patients.

Objective

To evaluate the effectiveness of ultrasound in detecting diabetic tendinopathy in type 2 diabetes mellitus (T2DM) patients by assessing plantar fascia (PF) thickness and stiffness.

Methods

This study included 70 T2DM patients with heel pain, diagnosed by American Diabetes Association (ADA). B mode ultrasound was used to evaluate PF thickness. Shear wave elastography (SWE) was used to assess PF stiffness.

Results

In T2DM patients, the PF thickness (PFT) was significantly thicker (4.40 ± 0.79 mm vs. 2.87 ± 0.26 mm, P < 0.05) and the shear wave velocity (SWV) of PF was significantly lower (3.09 ± 0.57 m/s vs. 4.00 ± 1.01 m/s, P < 0.05) than the control group. PFT and SWV values were strongly correlated with age (r = 0.880, −0.888) and BMI (r = 0.814, −0.853). ROC analysis showed that PFT > 4.33 mm had a sensitivity of 98.0% and specificity of 77.2% for diabetic tendinopathy, with an area under the ROC curve (AUROC) of 0.956, SWV < 3.22 m/s had a sensitivity of 86.3% and specificity of 60.5% (AUROC = 0.789).

Conclusion

Ultrasound is a non-invasive and efficient diagnostic tool for PF in T2DM patients.