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ECR 2015 / C-1005
Sonoelastography on diabetic heel pads: a feasibility study
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Congress: ECR 2015
Poster No.: C-1005
Type: Scientific Exhibit
Keywords: Outcomes, Diagnostic procedure, Ultrasound, Elastography, Musculoskeletal system, Musculoskeletal soft tissue, Extremities
Authors: S. Matteoli, L. Forzoni, F. Vannetti, A. Virga, A. Corvi, R. Molino-Lova; Firenze/IT


The aim of this study was to investigate whether it is possible to differentiate between diabetic and healthy heel pads in terms of elasticity by means of ElaXto sonoelstography.

To date, sonoelastography has not been used for clinical correlation of heel pad elasticity. Over the past decades, ultrasound technology has been one of the most popular techniques for the evaluation of the morphology and properties tissues [7], but reported controversial results in diabetic patients. Huntley and Walter (1990) [8] and Hashmi et al. (2006) [9] showed that the plantar tissue thickness was significantly higher in diabetic patients without neuropathy compared to healthy subjects; Klaesner et al. (2002) [10] reported that the plantar tissue for people with diabetic neuropathy was significantly more rigid than in healthy subjects of the same age; Gooding G. et al (1986) [11] the heel pad thickness in controls was greater than that of the diabetics without foot ulcers; Robertson et al. (2002) [12] showed, instead, no significant difference in the soft tissue thickness between diabetic patients and controls. Further investigations are thus needed to clarify the effects of diabetes on the heel pad on the basis of the characteristics of inhomogeneous soft tissue.

Our findings suggests that sonoelastography could be used as a predictor of clinical evidence that such a body area leads to diabetes.

A portable US system, with the capability of sonoelastography modality and high level of image quality, was used due to its transportability. Indeed, many of the subjects with heel pain or heel injuries often have limited mobility. Moreover, sonoelastography is a non-invasive method to support the physician in assessing tissue elasticity. US diagnostic technology is in general cost effective, widely available, real-time, not-ionizing (therefore enabling also repetitive follow ups) and suitable, in case of portable systems, also for home diagnosis (being the US system used for those tests, able to be transported, it can avoid to move the patient which is an interesting plus in case of reduced motility subjects). Sonoelastography enables the clear differentiation of soft and hard structures with the desired Region of Interest (ROI) [13]. Moreover, it is a relatively-quantified technology: tissues are shown as harder or softer in a relative and not absolute manner, therefore, tissues soft are softer than the average value of the tissues within the ROI, while they can be hard if compared to other tissues.

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