<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03231150</url>
  </required_header>
  <id_info>
    <org_study_id>PPMC-04</org_study_id>
    <nct_id>NCT03231150</nct_id>
  </id_info>
  <brief_title>Plantar Fasciitis Randomized Clinical Control Trial</brief_title>
  <acronym>PF-RCT</acronym>
  <official_title>Randomized Clinical Study to Evaluate Ultrasound Guided Injection Therapy Versus Topographic Injection Therapy for Plantar Fasciitis</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>University of Pennsylvania</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>University of Pennsylvania</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
    <is_us_export>No</is_us_export>
  </oversight_info>
  <brief_summary>
    <textblock>
      The primary aim of this clinical experiment is to compare, in terms of pain relief measured&#xD;
      using the 10-cm visual analog scale (VAS) pain score (5-7), the clinical results of&#xD;
      ultrasound-guided injection (USGI) versus anatomic topography-guided injection (ATGI) of&#xD;
      corticosteroid for the treatment of proximal PF. Secondary aims will be to compare&#xD;
      foot-related quality of life, as measured using the Foot Function Index (FFI)and the Bristol&#xD;
      Foot Score (BFS), between the injection groups, and also to compare the pre-injection to&#xD;
      late-term post-injection thickness of the plantar fascia as measured in the nested USGI&#xD;
      group.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Clinically, proximal PF causes plantar heel pain, which may extend into the proximal portion&#xD;
      of the plantar longitudinal arch. Typically, the pain is most notable upon initial weight&#xD;
      bearing ambulation (post-static dyskinesia, PSD), such as the first step in the morning or&#xD;
      following a period of non-weight bearing or rest. This can be attributed to walking on hard&#xD;
      surfaces or barefoot, prolonged weight bearing activity, inadequate stretching and use of&#xD;
      poor footwear, as well as increased amounts of walking. Standard treatment of PF includes the&#xD;
      use of foot orthotics, both pre-fabricated and custom molded, physical therapy and&#xD;
      myotendinous stretching, splinting or strapping the foot, nonsteroidal anti-inflammatory&#xD;
      drugs, ice, and corticosteroid injections. Ultrasonography (US) can be useful for examining&#xD;
      the plantar fascia, which typically measures between 2 mm to 4 mm in thickness, and findings&#xD;
      indicative of PF include diffuse hypoechogenicity at the calcaneal attachment of the plantar&#xD;
      fascia, loss of definition between the plantar fascia and the surrounding soft tissues,&#xD;
      peri-insertion edema, and thickness over 4.5 mm. Local infiltration of corticosteroids has&#xD;
      been used to treat PF since the 1950s. Despite this being a well established treatment, there&#xD;
      are still unexamined features of this form of intervention, including the method of&#xD;
      injection, type of steroid used, concurrent use of localanesthetic agents, concurrent use of&#xD;
      orthoses and/or supportive arch strapping, concurrent physical therapy, and the use of&#xD;
      ultrasonographic guidance of the corticosteroid injection. The primary aim of this clinical&#xD;
      experiment is to compare, in terms of pain relief measured using the 10-cm visual analog&#xD;
      scale (VAS) pain score (5-7), the clinical results of ultrasound-guided injection (USGI)&#xD;
      versus anatomic topography-guided injection (ATGI) of corticosteroid for the treatment of&#xD;
      proximal PF. Secondary aims will be to compare foot-related quality of life, as measured&#xD;
      using the Foot Function Index (FFI)and the Bristol Foot Score (BFS), between the injection&#xD;
      groups, and also to compare the pre-injection to late-term post-injection thickness of the&#xD;
      plantar fascia as measured in the nested USGI group.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Recruiting</overall_status>
  <start_date type="Actual">March 28, 2017</start_date>
  <completion_date type="Anticipated">January 31, 2024</completion_date>
  <primary_completion_date type="Anticipated">January 31, 2024</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Single Group Assignment</intervention_model>
    <intervention_model_description>This investigation will be chronologically divided into four stages that will commence after procurement of institutional review board (IRB) approval and funding, namely: 1) screening and enrollment, 2) random treatment allocation and treatment, 3) data collection and analysis, and 4) presentation and publication. We anticipate that it will take approximately 23.5 months to execute the clinical experiment and to prepare the report for publication.</intervention_model_description>
    <primary_purpose>Treatment</primary_purpose>
    <masking>Double (Care Provider, Investigator)</masking>
    <masking_description>Participants that do not experience at least a 50% reduction in pain following phase 1 will undergo randomization to either USGI or ATGI, both injections consisting of 0.5 ml 0.25% bupivacaine plain, 0.5 ml dexamethasone phosphate, and 0.5 ml triamcinolone acetonide 40 mg/ml. Execution of the USGI will employ an actual diagnostic US machine (Voluson E8 Expert, General Electric Company, Boston, MA) and a plantarmedial approach, whereas execution of the ATGI will employ a sham diagnostic US machine and a plantarmedial approach. The patients will be randomized into these groups by a specialized statistical computerized system that randomly selects a number to the participant. An even or an odd number represents which form of injection the patient is to receive.</masking_description>
  </study_design_info>
  <primary_outcome>
    <measure>Change in VAS pain score at post injection periods with use of USGI</measure>
    <time_frame>Baseline to 3 months, 6 month, 9 month, and 12 month follow up</time_frame>
    <description>with the primary efficacy endpoint being the 3-month post injection pain score</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Change in VAS pain score at post injection periods with use of ATGI</measure>
    <time_frame>Baseline to 3 months, 6 month, 9 month, and 12 month follow up</time_frame>
    <description>with the primary efficacy endpoint being the 3-month post injection pain score</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Observation of normal plantar fascia after treatment as measured by ultrasound (US)</measure>
    <time_frame>Baseline to 12 month follow up</time_frame>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Foot-related quality of life outcomes as measured with use of the FFI</measure>
    <time_frame>Baseline to 3 months, 6 month, 9 month, and 12 month follow up</time_frame>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Foot-related quality of life outcomes as measured with use of the BFS</measure>
    <time_frame>Baseline to 3 months, 6 month, 9 month, and 12 month follow up</time_frame>
  </secondary_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Anticipated">62</enrollment>
  <condition>Plantar Fascitis</condition>
  <arm_group>
    <arm_group_label>Anatomical injection</arm_group_label>
    <arm_group_type>Active Comparator</arm_group_type>
    <description>Once patient has been randomized, if placed in the anatomically-guided injection group, the medial band of the plantar fascia origin on the calcaneus will be palpated and marked approximately. In the clinical setting, a sham ultrasound machine will be utilized to &quot;locate&quot; the plantar fascia keeping the patient blinded to the treatment modality. The area will then be prepped with alcohol to the medial heel and utilizing a medial approach, an injection of 0.5 cc 0.5% bupivacaine, 0.5 cc dexamethasone and 0.25 cc triamcinolone acetamide 40 mg/mL will be administered into the area surrounding the plantar fascia. The area will then be cleaned will alcohol and dressed with a small elastic bandage.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Ultrasound Guided Injection</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>Once patient has been randomized, if placed in the USGI group, the patient will be scheduled for an ultrasound therapy in the radiology department at Penn Presbyterian Medical Center. In this setting, the patient will be informed that in order to keep them blinded, that all patients must have either injection performed in the radiology department and that the ultrasound machine utilized will either be on or off during the injection keeping the patient blinded to the treatment modality. The area will then be prepped with alcohol to the medial heel and utilizing a medial approach, an injection of 0.5 cc 0.5% bupivacaine, 0.5 cc dexamethasone and 0.25 cc triamcinolone acetamide 40 mg/mL will be administered into the area surrounding the plantar fascia. The area will then be cleaned will alcohol and dressed with a small elastic bandage.</description>
  </arm_group>
  <intervention>
    <intervention_type>Procedure</intervention_type>
    <intervention_name>Local Steroid Injection into the plantar heel</intervention_name>
    <description>Injections consisting of 0.5 ml 0.25% bupivacaine plain, 0.5 ml dexamethasone phosphate, and 0.5 ml triamcinolone acetonide 40 mg/ml.</description>
    <arm_group_label>Anatomical injection</arm_group_label>
    <arm_group_label>Ultrasound Guided Injection</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Procedure</intervention_type>
    <intervention_name>Ultrasound Guided Injection</intervention_name>
    <description>Execution of the USGI will employ an actual diagnostic US machine (Voluson E8 Expert, General Electric Company, Boston, MA) and a plantarmedial approach</description>
    <arm_group_label>Ultrasound Guided Injection</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Procedure</intervention_type>
    <intervention_name>Anatomical Guided injection</intervention_name>
    <description>Execution of the ATGI will employ a sham diagnostic US machine and a plantarmedial approach.</description>
    <arm_group_label>Anatomical injection</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  Pain on palpation along the proximal plantar fascia with or without radiographic&#xD;
             evidence of a plantar calcaneal bone spur&#xD;
&#xD;
          -  ≥18 years of age&#xD;
&#xD;
          -  Male or non-pregnant female of any ethnicity or race&#xD;
&#xD;
          -  Active, former or non smoker&#xD;
&#xD;
          -  With or without peripheral vascular disease without lower extremity intermittent&#xD;
             claudication or rest pain&#xD;
&#xD;
          -  With or without diabetes mellitus without polyneuropathy&#xD;
&#xD;
          -  With or without collagen vascular disease without lower extremity wound formation.&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  Known drug or alcohol dependence&#xD;
&#xD;
          -  Chronic pain syndrome or lumbosacral radiculitis&#xD;
&#xD;
          -  Neurological condition that requires the use of analgesic medications or anti-seizure&#xD;
             or neuroleptic medications&#xD;
&#xD;
          -  Peripheral vascular disease that results in rest pain or intermittent claudication or&#xD;
             venous stasis ulceration&#xD;
&#xD;
          -  Calcaneal stress fracture or show evidence of a foreign body or tumor of the affected&#xD;
             heel as viewed radiographically&#xD;
&#xD;
          -  Pregnant females&#xD;
&#xD;
          -  Known allergy to any of the components of the injection therapy&#xD;
&#xD;
          -  Previously suffered a rupture or surgery of the plantar fascia within the 5 years&#xD;
             preceding participation in the investigation&#xD;
&#xD;
          -  Existing or prior osteomyelitis of the involved calcaneus&#xD;
&#xD;
          -  Unable to consent to participation in clinical research or currently be involved in&#xD;
             another clinical investigation.&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>Accepts Healthy Volunteers</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Donald S Malay, DPM</last_name>
    <role>Principal Investigator</role>
    <affiliation>Penn Presbyterian Medical Center</affiliation>
  </overall_official>
  <overall_contact>
    <last_name>Donald S Malay, DPM</last_name>
    <phone>4848440755</phone>
    <email>malaydsm@gmail.com</email>
  </overall_contact>
  <overall_contact_backup>
    <last_name>Hye R Kim, DPM</last_name>
    <phone>443-765-6588</phone>
    <email>hearin86@gmail.com</email>
  </overall_contact_backup>
  <location>
    <facility>
      <name>Penn Presbyterian Medical Center</name>
      <address>
        <city>Philadelphia</city>
        <state>Pennsylvania</state>
        <zip>19104</zip>
        <country>United States</country>
      </address>
    </facility>
    <status>Recruiting</status>
    <contact>
      <last_name>Donald S Malay, DPM</last_name>
      <phone>484-844-0755</phone>
      <email>malaydsm@gmail.com</email>
    </contact>
    <investigator>
      <last_name>Brittany Winfield, DPM</last_name>
      <role>Sub-Investigator</role>
    </investigator>
    <investigator>
      <last_name>Lauren E Pruner, DPM</last_name>
      <role>Sub-Investigator</role>
    </investigator>
    <investigator>
      <last_name>Raafae Hussain, DPM</last_name>
      <role>Sub-Investigator</role>
    </investigator>
    <investigator>
      <last_name>Paul Niziolek, MD</last_name>
      <role>Sub-Investigator</role>
    </investigator>
    <investigator>
      <last_name>Viviane Khoury, MD</last_name>
      <role>Sub-Investigator</role>
    </investigator>
  </location>
  <location_countries>
    <country>United States</country>
  </location_countries>
  <results_reference>
    <citation>Ang TW. The effectiveness of corticosteroid injection in the treatment of plantar fasciitis. Singapore Med J. 2015 Aug;56(8):423-32. doi: 10.11622/smedj.2015118.</citation>
    <PMID>26311907</PMID>
  </results_reference>
  <results_reference>
    <citation>Weil L Jr, Glover JP, Weil LS Sr. A new minimally invasive technique for treating plantar fasciosis using bipolar radiofrequency: a prospective analysis. Foot Ankle Spec. 2008 Feb;1(1):13-8. doi: 10.1177/1938640007312318..</citation>
    <PMID>19825686</PMID>
  </results_reference>
  <results_reference>
    <citation>Young CC, Rutherford DS, Niedfeldt MW. Treatment of plantar fasciitis. Am Fam Physician. 2001 Feb 1;63(3):467-74, 477-8. Erratum In: Am Fam Physician 2001 Aug 15;64(4):570.</citation>
    <PMID>11272297</PMID>
  </results_reference>
  <results_reference>
    <citation>Buchbinder R. Clinical practice. Plantar fasciitis. N Engl J Med. 2004 May 20;350(21):2159-66. doi: 10.1056/NEJMcp032745. No abstract available.</citation>
    <PMID>15152061</PMID>
  </results_reference>
  <results_reference>
    <citation>Wessel J. The reliability and validity of pain threshold measurements in osteoarthritis of the knee. Scand J Rheumatol. 1995;24(4):238-42. doi: 10.3109/03009749509100881.</citation>
    <PMID>7481589</PMID>
  </results_reference>
  <results_reference>
    <citation>Lundeberg T, Lund I, Dahlin L, Borg E, Gustafsson C, Sandin L, Rosen A, Kowalski J, Eriksson SV. Reliability and responsiveness of three different pain assessments. J Rehabil Med. 2001 Nov;33(6):279-83. doi: 10.1080/165019701753236473.</citation>
    <PMID>11766958</PMID>
  </results_reference>
  <results_reference>
    <citation>Bijur PE, Silver W, Gallagher EJ. Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med. 2001 Dec;8(12):1153-7. doi: 10.1111/j.1553-2712.2001.tb01132.x.</citation>
    <PMID>11733293</PMID>
  </results_reference>
  <results_reference>
    <citation>Budiman-Mak E, Conrad KJ, Roach KE. The Foot Function Index: a measure of foot pain and disability. J Clin Epidemiol. 1991;44(6):561-70. doi: 10.1016/0895-4356(91)90220-4.</citation>
    <PMID>2037861</PMID>
  </results_reference>
  <results_reference>
    <citation>Barnett S, Campbell R, Harvey I. The Bristol Foot Score: developing a patient-based foot-health measure. J Am Podiatr Med Assoc. 2005 May-Jun;95(3):264-72. doi: 10.7547/0950264.</citation>
    <PMID>15901814</PMID>
  </results_reference>
  <results_reference>
    <citation>Tsai WC, Wang CL, Tang FT, Hsu TC, Hsu KH, Wong MK. Treatment of proximal plantar fasciitis with ultrasound-guided steroid injection. Arch Phys Med Rehabil. 2000 Oct;81(10):1416-21. doi: 10.1053/apmr.2000.9175.</citation>
    <PMID>11030509</PMID>
  </results_reference>
  <results_reference>
    <citation>Tsai WC, Hsu CC, Chen CP, Chen MJ, Yu TY, Chen YJ. Plantar fasciitis treated with local steroid injection: comparison between sonographic and palpation guidance. J Clin Ultrasound. 2006 Jan;34(1):12-6. doi: 10.1002/jcu.20177.</citation>
    <PMID>16353228</PMID>
  </results_reference>
  <results_reference>
    <citation>Chen CM, Chen JS, Tsai WC, Hsu HC, Chen KH, Lin CH. Effectiveness of device-assisted ultrasound-guided steroid injection for treating plantar fasciitis. Am J Phys Med Rehabil. 2013 Jul;92(7):597-605. doi: 10.1097/PHM.0b013e318278a831.</citation>
    <PMID>23221670</PMID>
  </results_reference>
  <results_reference>
    <citation>Li Z, Xia C, Yu A, Qi B. Ultrasound- versus palpation-guided injection of corticosteroid for plantar fasciitis: a meta-analysis. PLoS One. 2014 Mar 21;9(3):e92671. doi: 10.1371/journal.pone.0092671. eCollection 2014.</citation>
    <PMID>24658102</PMID>
  </results_reference>
  <verification_date>February 2023</verification_date>
  <study_first_submitted>July 21, 2017</study_first_submitted>
  <study_first_submitted_qc>July 24, 2017</study_first_submitted_qc>
  <study_first_posted type="Actual">July 27, 2017</study_first_posted>
  <last_update_submitted>February 24, 2023</last_update_submitted>
  <last_update_submitted_qc>February 24, 2023</last_update_submitted_qc>
  <last_update_posted type="Actual">February 27, 2023</last_update_posted>
  <responsible_party>
    <responsible_party_type>Sponsor</responsible_party_type>
  </responsible_party>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Fasciitis</mesh_term>
    <mesh_term>Fasciitis, Plantar</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>No</sharing_ipd>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03231150
org study id: PPMC-04
nct id: NCT03231150
lead sponsor: 
has dmc: No
is fda regulated drug: No
is fda regulated device: No
is us export: No
The primary aim of this clinical experiment is to compare, in terms of pain relief measured
      using the 10-cm visual analog scale (VAS) pain score (5-7), the clinical results of
      ultrasound-guided injection (USGI) versus anatomic topography-guided injection (ATGI) of
      corticosteroid for the treatment of proximal PF. Secondary aims will be to compare
      foot-related quality of life, as measured using the Foot Function Index (FFI)and the Bristol
      Foot Score (BFS), between the injection groups, and also to compare the pre-injection to
      late-term post-injection thickness of the plantar fascia as measured in the nested USGI
      group.
Clinically, proximal PF causes plantar heel pain, which may extend into the proximal portion
      of the plantar longitudinal arch. Typically, the pain is most notable upon initial weight
      bearing ambulation (post-static dyskinesia, PSD), such as the first step in the morning or
      following a period of non-weight bearing or rest. This can be attributed to walking on hard
      surfaces or barefoot, prolonged weight bearing activity, inadequate stretching and use of
      poor footwear, as well as increased amounts of walking. Standard treatment of PF includes the
      use of foot orthotics, both pre-fabricated and custom molded, physical therapy and
      myotendinous stretching, splinting or strapping the foot, nonsteroidal anti-inflammatory
      drugs, ice, and corticosteroid injections. Ultrasonography (US) can be useful for examining
      the plantar fascia, which typically measures between 2 mm to 4 mm in thickness, and findings
      indicative of PF include diffuse hypoechogenicity at the calcaneal attachment of the plantar
      fascia, loss of definition between the plantar fascia and the surrounding soft tissues,
      peri-insertion edema, and thickness over 4.5 mm. Local infiltration of corticosteroids has
      been used to treat PF since the 1950s. Despite this being a well established treatment, there
      are still unexamined features of this form of intervention, including the method of
      injection, type of steroid used, concurrent use of localanesthetic agents, concurrent use of
      orthoses and/or supportive arch strapping, concurrent physical therapy, and the use of
      ultrasonographic guidance of the corticosteroid injection. The primary aim of this clinical
      experiment is to compare, in terms of pain relief measured using the 10-cm visual analog
      scale (VAS) pain score (5-7), the clinical results of ultrasound-guided injection (USGI)
      versus anatomic topography-guided injection (ATGI) of corticosteroid for the treatment of
      proximal PF. Secondary aims will be to compare foot-related quality of life, as measured
      using the Foot Function Index (FFI)and the Bristol Foot Score (BFS), between the injection
      groups, and also to compare the pre-injection to late-term post-injection thickness of the
      plantar fascia as measured in the nested USGI group.
allocation: Randomized
intervention model: Single Group Assignment
intervention model description: This investigation will be chronologically divided into four stages that will commence after procurement of institutional review board (IRB) approval and funding, namely: 1) screening and enrollment, 2) random treatment allocation and treatment, 3) data collection and analysis, and 4) presentation and publication. We anticipate that it will take approximately 23.5 months to execute the clinical experiment and to prepare the report for publication.
primary purpose: Treatment
masking: Double (Care Provider, Investigator)
masking description: Participants that do not experience at least a 50% reduction in pain following phase 1 will undergo randomization to either USGI or ATGI, both injections consisting of 0.5 ml 0.25% bupivacaine plain, 0.5 ml dexamethasone phosphate, and 0.5 ml triamcinolone acetonide 40 mg/ml. Execution of the USGI will employ an actual diagnostic US machine (Voluson E8 Expert, General Electric Company, Boston, MA) and a plantarmedial approach, whereas execution of the ATGI will employ a sham diagnostic US machine and a plantarmedial approach. The patients will be randomized into these groups by a specialized statistical computerized system that randomly selects a number to the participant. An even or an odd number represents which form of injection the patient is to receive.
measure: Change in VAS pain score at post injection periods with use of USGI
time frame: Baseline to 3 months, 6 month, 9 month, and 12 month follow up
description: with the primary efficacy endpoint being the 3-month post injection pain score
measure: Change in VAS pain score at post injection periods with use of ATGI
time frame: Baseline to 3 months, 6 month, 9 month, and 12 month follow up
description: with the primary efficacy endpoint being the 3-month post injection pain score
measure: Observation of normal plantar fascia after treatment as measured by ultrasound (US)
time frame: Baseline to 12 month follow up
measure: Foot-related quality of life outcomes as measured with use of the FFI
time frame: Baseline to 3 months, 6 month, 9 month, and 12 month follow up
measure: Foot-related quality of life outcomes as measured with use of the BFS
time frame: Baseline to 3 months, 6 month, 9 month, and 12 month follow up
arm group label: Anatomical injection
arm group type: Active Comparator
description: Once patient has been randomized, if placed in the anatomically-guided injection group, the medial band of the plantar fascia origin on the calcaneus will be palpated and marked approximately. In the clinical setting, a sham ultrasound machine will be utilized to "locate" the plantar fascia keeping the patient blinded to the treatment modality. The area will then be prepped with alcohol to the medial heel and utilizing a medial approach, an injection of 0.5 cc 0.5% bupivacaine, 0.5 cc dexamethasone and 0.25 cc triamcinolone acetamide 40 mg/mL will be administered into the area surrounding the plantar fascia. The area will then be cleaned will alcohol and dressed with a small elastic bandage.
arm group label: Ultrasound Guided Injection
arm group type: Experimental
description: Once patient has been randomized, if placed in the USGI group, the patient will be scheduled for an ultrasound therapy in the radiology department at Penn Presbyterian Medical Center. In this setting, the patient will be informed that in order to keep them blinded, that all patients must have either injection performed in the radiology department and that the ultrasound machine utilized will either be on or off during the injection keeping the patient blinded to the treatment modality. The area will then be prepped with alcohol to the medial heel and utilizing a medial approach, an injection of 0.5 cc 0.5% bupivacaine, 0.5 cc dexamethasone and 0.25 cc triamcinolone acetamide 40 mg/mL will be administered into the area surrounding the plantar fascia. The area will then be cleaned will alcohol and dressed with a small elastic bandage.
intervention type: Procedure
intervention name: Local Steroid Injection into the plantar heel
description: Injections consisting of 0.5 ml 0.25% bupivacaine plain, 0.5 ml dexamethasone phosphate, and 0.5 ml triamcinolone acetonide 40 mg/ml.
arm group label: Anatomical injection
arm group label: Ultrasound Guided Injection
intervention type: Procedure
intervention name: Ultrasound Guided Injection
description: Execution of the USGI will employ an actual diagnostic US machine (Voluson E8 Expert, General Electric Company, Boston, MA) and a plantarmedial approach
arm group label: Ultrasound Guided Injection
intervention type: Procedure
intervention name: Anatomical Guided injection
description: Execution of the ATGI will employ a sham diagnostic US machine and a plantarmedial approach.
arm group label: Anatomical injection
criteria: 
gender: All
minimum age: 18 Years
maximum age: N/A
healthy volunteers: Accepts Healthy Volunteers
last name: Donald S Malay, DPM
role: Principal Investigator
affiliation: Penn Presbyterian Medical Center
last name: Donald S Malay, DPM
phone: 4848440755
email: malaydsm@gmail.com
last name: Hye R Kim, DPM
phone: 443-765-6588
email: hearin86@gmail.com
facility: 
status: Recruiting
contact: 
investigator: 
investigator: 
investigator: 
investigator: 
investigator: 
country: United States
citation: Ang TW. The effectiveness of corticosteroid injection in the treatment of plantar fasciitis. Singapore Med J. 2015 Aug;56(8):423-32. doi: 10.11622/smedj.2015118.
PMID: 26311907
citation: Weil L Jr, Glover JP, Weil LS Sr. A new minimally invasive technique for treating plantar fasciosis using bipolar radiofrequency: a prospective analysis. Foot Ankle Spec. 2008 Feb;1(1):13-8. doi: 10.1177/1938640007312318..
PMID: 19825686
citation: Young CC, Rutherford DS, Niedfeldt MW. Treatment of plantar fasciitis. Am Fam Physician. 2001 Feb 1;63(3):467-74, 477-8. Erratum In: Am Fam Physician 2001 Aug 15;64(4):570.
PMID: 11272297
citation: Buchbinder R. Clinical practice. Plantar fasciitis. N Engl J Med. 2004 May 20;350(21):2159-66. doi: 10.1056/NEJMcp032745. No abstract available.
PMID: 15152061
citation: Wessel J. The reliability and validity of pain threshold measurements in osteoarthritis of the knee. Scand J Rheumatol. 1995;24(4):238-42. doi: 10.3109/03009749509100881.
PMID: 7481589
citation: Lundeberg T, Lund I, Dahlin L, Borg E, Gustafsson C, Sandin L, Rosen A, Kowalski J, Eriksson SV. Reliability and responsiveness of three different pain assessments. J Rehabil Med. 2001 Nov;33(6):279-83. doi: 10.1080/165019701753236473.
PMID: 11766958
citation: Bijur PE, Silver W, Gallagher EJ. Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med. 2001 Dec;8(12):1153-7. doi: 10.1111/j.1553-2712.2001.tb01132.x.
PMID: 11733293
citation: Budiman-Mak E, Conrad KJ, Roach KE. The Foot Function Index: a measure of foot pain and disability. J Clin Epidemiol. 1991;44(6):561-70. doi: 10.1016/0895-4356(91)90220-4.
PMID: 2037861
citation: Barnett S, Campbell R, Harvey I. The Bristol Foot Score: developing a patient-based foot-health measure. J Am Podiatr Med Assoc. 2005 May-Jun;95(3):264-72. doi: 10.7547/0950264.
PMID: 15901814
citation: Tsai WC, Wang CL, Tang FT, Hsu TC, Hsu KH, Wong MK. Treatment of proximal plantar fasciitis with ultrasound-guided steroid injection. Arch Phys Med Rehabil. 2000 Oct;81(10):1416-21. doi: 10.1053/apmr.2000.9175.
PMID: 11030509
citation: Tsai WC, Hsu CC, Chen CP, Chen MJ, Yu TY, Chen YJ. Plantar fasciitis treated with local steroid injection: comparison between sonographic and palpation guidance. J Clin Ultrasound. 2006 Jan;34(1):12-6. doi: 10.1002/jcu.20177.
PMID: 16353228
citation: Chen CM, Chen JS, Tsai WC, Hsu HC, Chen KH, Lin CH. Effectiveness of device-assisted ultrasound-guided steroid injection for treating plantar fasciitis. Am J Phys Med Rehabil. 2013 Jul;92(7):597-605. doi: 10.1097/PHM.0b013e318278a831.
PMID: 23221670
citation: Li Z, Xia C, Yu A, Qi B. Ultrasound- versus palpation-guided injection of corticosteroid for plantar fasciitis: a meta-analysis. PLoS One. 2014 Mar 21;9(3):e92671. doi: 10.1371/journal.pone.0092671. eCollection 2014.
PMID: 24658102
responsible party type: Sponsor
mesh term: Fasciitis
mesh term: Fasciitis, Plantar
sharing ipd: No