Type:
Educational Exhibit
Keywords:
Motility, Puncture, Ultrasound, Musculoskeletal soft tissue
Authors:
G. Freire1, J. Morais1, L. Gargaté1, P. D. Afonso2; 1Loures/PT, 2Lisbon/PT
DOI:
10.1594/ecr2018/C-1722
Findings and procedure details
Ultrasound-guided EPI technique was used for the treatment of plantar fasciitis that was refractory to conservative measures.
All patients had undergone physical therapy and anti-inflammatory therapy with no clinical satisfactory results.
In our department,
this procedure is performed by a musculoskeletal radiologist and a Physical Medicine and Rehabilitation physician.
It consist in the ultrasound-guided puncture of the thickest area of the plantar fascia,
corresponding to the area of most pain.
Then,
galvanic current is applied.
We usually apply 600-1200 J with 1 mA intensity.
Puncture site will progressively appear as a hyperechoic area,
corresponding to cellular necrosis (fig.
2).
So far,
we have treated 17 patients with this technique.
Patients mean age was 51 and 76.5% were females.
Patients often present moderate pain after treatment,
which disappears within two days,
according to our experience.
Two or three sessions of EPI procedure are needed,
with one week interval between.
Ten patients (58.8%) demonstrated symptomatic relief,
from which four patients (40%) had no pain one month after treatment.
The remaining seven had no clinical improvement with EPI technique.
EPI technique can have favourable results in the treatment of plantar fasciitis refractory to conventional therapy.
A prospective study should be performed,
in order to assess its true efficacy.