New Approach for B-Mode Ultrasound (US) Evaluation of the Plantar Aponeurosis (PA) Thickness in Healthy Subjects

Abstract

Purpose To compare ultrasound (US) measurements in the sagittal and axial plane of the plantar aponeurosis (PA) in healthy subjects.

Materials and Methods PA thickness was measured in 40 healthy subjects (mean age: 34 years) by two radiologists using US in sagittal, axial medial and axial lateral planes. Subjects were classified according to gender (female and male) and age (18 – 35 versus 50 – 75 years). All measurements were compared and the interobserver agreement was calculated.

Results The PA was medially significantly thicker than laterally (mean ± std 3.1 ± 0.7 mm versus 2.5 ± 0.5 mm respectively, P< 0.001). A significant difference was found between males and females (3.3 ± 0.7 mm versus 2.9 ± 0.6 mm medially and 2.7 ± 0.6 mm versus 2.3 ± 0.4 mm laterally, p < 0.05) and between the older and younger age groups (3.8 ± 0.6 mm versus 2.8 ± 0.4 mm medially and 3.1 ± 0.4 mm versus 2.3 ± 0.4 mm laterally, p < 0.001). Good interobserver agreement was detected (0.74).

Conclusion Measurement of central and lateral fascicles of the plantar aponeurosis in both planes (sagittal and axial) is recommended in the daily routine.

Key points 

• US examination of the central and lateral fascicles of the PA was feasible.

• PA thickness measurements showed significant differences based on age and gender.

• There was good interobserver correlation between both examiners despite the major difference in experience.

• Scanning of two planes for the PA is recommended in the daily routine.

• PA thickness measurement by US is a fast and reliable method for junior radiologists.

Citation Format

• Abd Ellah MM, Kremser C, Strobl S et al. New Approach for B-Mode Ultrasound (US) Evaluation of the Plantar Aponeurosis (PA) Thickness in Healthy Subjects. Fortschr Röntgenstr 2019; 191: 333 – 339

Zusammenfassung

Ziel Vergleich von Ultraschall (US)-Messungen in sagittaler und axialer Ebene an der Aponeurosis plantaris (PA) bei gesunden Personen.

Material und Methoden Die PA-Dicke wurde bei 40 gesunden Personen (mittleres Alter 34 Jahre) von 2 Radiologen mittels US in sagittaler, axial medialer und axial lateraler Ebene gemessen. Die Teilnehmer wurden entsprechend ihres Geschlechts (weiblich/männlich) und ihres Alters (18 – 35 versus 50 – 75 Jahre) klassifiziert. Alle Messungen wurden verglichen und das Inter-Observer-Agreement berechnet.

Ergebnisse PA war medial signifikant dicker als lateral (mean± std 3,1 ± 0,7 mm versus 2,5 ± 0,5 mm, p < 0,001). Ein signifikanter Unterschied wurde auch zwischen männlichen und weiblichen Personen (3,3 ± 0,7 mm versus 2,9 ± 0,6 mm medial und 2,7 ± 0,6 mm versus 2,3 ± 0,4 mm lateral, p < 0,05) und zwischen der älteren und jüngeren Altersgruppe (3,8 ± 0,6 mm versus 2,8 ± 0,4 mm medial und 3,1 ± 0,4 mm versus 2,3 ± 0,4 mm lateral, p < 0,001) gefunden. Ein gutes Inter-Observer-Agreement (0,74) wurde beobachtet.

Schlussfolgerungen Die US-Messung der PA-Dicke in 2 verschiedenen Messebenen (sagittal und axial) kann für den klinischen Einsatz als Routine-Standardmethode empfohlen werden.

Kernaussagen 

• Die US-Untersuchung der zentralen und lateralen Faszikel der PA war möglich.

• Die PA-Dickenmessung zeigte signifikante Unterschiede zwischen Geschlechts- und Altersgruppen.

• Gutes Inter-Observer-Agreement trotz deutlicher Erfahrungsunterschiede.

• Untersuchung der PA in 2 Ebenen wird für die Routine empfohlen.

• Die PA-Dickenmessung mittels US ist eine schnelle und zuverlässige Methode für Nachwuchsradiologen.

Key words

soft tissues - ultrasound - anatomy - foot

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