The association of physical examination findings and functional status with radiological and clinical variables in plantar heel pain

Abstract

Objective: We aimed at exploring the correlation among demographic features, clinical findings, radiological and functional status of patients with plantar heel pain. Material and Methods: Patients with plantar heel pain who had lateral feet X-rays in last 6 months were evaluated retrospectively. Patients were questioned for duration of symptoms and whether there is pain with first step in the morning. The presence of epin calcanei was evaluated on the lateral X-rays of feet. Clinical evaluation is made by heel press test, pain intensity by 10cm visual analog scale(VAS), and functional evaluation by the Rearfoot Score of the American Orthopaedic Foot and Ankle Society (RFS). Results: Seventy-one patients, 112 feet were evaluated. The mean body mass index, duration of symptoms, VAS, RFS was respectively 30.26 ± 4.29 kg/m2, 20.00 ± 20.20 months, 8.6 ± 1.47, 52.17 ± 5.59. The pain with first step in the morning was present in 106(%94.6) feet, pain with palpation of heel was positive in 92(%82.1) feet. Epin calcanei was detected in lateral X-rays of 85(%75.9) feet. A significant correlation between pain with palpation of heel and epin calcanei findings on X-ray was detected (r= 0.282, p= 0.003). There was significant correlation between RFS and age(r= -0.302, p= 0.011), duration of symptoms (r=-0.310, p= 0.001), X-ray findings (r=-0.275, p= 0.003). A significant correlation was also detected between age and X-ray findings (r= 0.277, p= 0.019). Conclusion: Epin calcanei was frequently detected in lateral X-rays of feet in patients with plantar heel pain who have pain with pressing of heel and this frequency increases with increasing age. Epin calcanei findings in the X-ray, increased age and long duration of symptoms negatively effects the RFS. It is observed that pressing test with palpation of heel and RFS are effective evaluation methods for diagnosing epin calcanei because of their correlation with radiologic findings. Copyright © 2010 by Türk Tibbi Rehabilitasyon Kurumu Derne?i.