Relative Efficacy of Planar Bone Scan and SPECT/CT in Localizing the Site for Corticosteroid Injection in Plantar Fasciitis

Authors: Kamaleshwaran KK*, Bhattacharya A, Aggarwal S and Mittal B

DOI: 10.23880/ijnmre-16000102

Volume 1, Issue 1

Abstract

Purpose: Several studies have described the role of bone scintigraphy in the management of plantar fasciitis. This study was conducted to compare the relative efficacy of planar [99mTc] MDP bone scan and single photon emission computed tomography / computed tomography (SPECT/CT) in localizing the best site for corticosteroid injection in patients with plantar fasciitis.

Methods: Thirty heels of 30 patients with clinical diagnosis of plantar fasciitis were randomly assigned to two groups, i.e. planar scintigraphy-guided (Group A) and SPECT/CT guided (Group B) for steroid injection. Patients were evaluated for pain intensity before the injections and at follow-up after 6 weeks, with a 100 mm visual analog scale (VAS).

Results: There was significant improvement in VAS score in both the groups. VAS values before and after treatment were 7.4 ± 1.3 and 3.3 ± 2.4 in group A, and 7.4 ± 1.2 and 1.6 ±1.5 in group B respectively, which was statistically significant (P < 0.05). There was no difference between the pre-injection VAS values between the groups (P 0.98, MWU -0.021) but statistically significant difference post-injection (P 0.048, MWU 1.97).

Conclusion: [99mTc] MDP bone scintigraphy was useful in identifying the inflammatory focus in plantar fasciitis. SPECT/CT guided steroid injection demonstrated a significantly better treatment outcome compared to planar scintigraphy. While the study is limited by the small number of patients, the findings indicate that SPECT/CT-guided steroid injection may provide better pain relief in this condition.

Keywords:

Plantar fasciitis; [99mTc] MDP; Bone scintigraphy; SPECT/CT; Corticosteroid

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