Abstract

Objectives: In this review, we discuss the efficacy of minimally invasive injection therapies for the treatment of plantar fasciitis (PF) using ultrasound (US)-guidance compared to landmark-guided or alternative imaging modalities.

Materials and methods: A systematic review was conducted in accordance with the Cochrane methodology from April 2023 to August 2023. A multisystem search was performed including PubMed, Ovid Embase, Web of Science, and Scopus for English published articles. Branched logic was used to include articles containing terms regarding PF, US and injections. Two authors screened studies for eligibility, and any disagreements were resolved through discussion with a third reviewer. Risk-of-bias assessments were performed.

Results: The search identified 2,068 publications; six studies were included in the review, comparing various local delivery techniques for the treatment of PF. All studies compared US- to landmark-guided local steroid injections, with one study also comparing scintigraphic-guidance. In the short- to mid-term, there was a significant improvement using all delivery methods with only one study that utilized an angle-adjustable device to aid in needle placement with US guidance showing statistical improvement compared to landmark-guided injections.

Conclusion: This systematic review demonstrates that pain outcomes are comparable between US-guided and landmark-guided injections for PF. However, US-guided techniques may offer additional practical advantages, such as improved visualization of anatomy, potentially enhancing safety and patient confidence. Clinicians should consider these procedural benefits in conjunction with efficacy outcomes when making treatment decisions.

Citation:
Gharib M, Kasitinon D, Kowalske A, Özçakar L, Jain NB. Efficacy of plantar fascia injections under ultrasound guidance versus landmark and scintigraphic guidance: A systematic review. Arch ISPRM 2026;1(1):31-40. https://doi.org/10.5606/archisprm.2026.33.

N.B.J., L.Ö.: Dea/concept, control/supervision; N.B.J., M.G.: Design, analysis and/or interpretation; M.G., A.K.: Data collection and/or processing; A.K., M.G., D.K.: Literature review; M.G.: Writing the article; M.G., N.B.J., L.Ö.: Critical review; N/A.: References and fundings.

The authors declare that there are no conflicts of interest with respect to the research, authorship, and/or publication of this article.

The authors declare that there are no conflicts of interest with respect to the research, authorship, and/or publication of this article.

Data Availability
The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

AI Disclosure
The authors declare that artificial intelligence (AI) tools were not used, or were used solely for language editing, and had no role in data analysis, interpretation, or the formulation of conclusions. All scientific content, data interpretation, and conclusions are the sole responsibility of the authors. The authors further confirm that AI tools were not used to generate, fabricate, or ‘hallucinate’ references, and that all references have been carefully verified for accuracy.