**Ultrasonography Features of the Plantar Fascia Complex in Patients with Chronic Non-Insertional Achilles Tendinopathy: A Case-Control Study**

**Carlos Romero-Morales 1, Pedro Javier Martín-Llantino 1, César Calvo-Lobo 2, Daniel López-López 3,\*, Rubén Sánchez-Gómez 1,4, Blanca De-La-Cruz-Torres <sup>5</sup> and David Rodríguez-Sanz 1,4**


Received: 27 March 2019; Accepted: 30 April 2019; Published: 2 May 2019

**Abstract:** Purpose: The goal of the present study was to assess, by ultrasound imaging (USI), the thickness of the plantar fascia (PF) at the insertion of the calcaneus, mid and forefoot fascial locations, and the calcaneal fat pad (CFP) in patients with Achilles tendinopathy (AT). Methods: An observational case-control study. A total sample of 143 individuals from 18 to 55 years was evaluated by USI in the study. The sample was divided into two groups: A group composed of the chronic non-insertional AT (*n* = 71) and B group comprised by healthy subjects (*n* = 72). The PF thicknesses at insertion on the calcaneus, midfoot, rearfoot and CFP were evaluated by USI. Results: the CFP and PF at the calcaneus thickness showed statistically significant differences (*P* < 0.01) with a decrease for the tendinopathy group with respect to the control group. For the PF midfoot and forefoot thickness, no significant differences (*P* > 0.05) were observed between groups. Conclusion: The thickness of the PF at the insertion and the CPF is reduced in patients with AT measured by USI.

**Keywords:** ultrasonography; Achilles tendon; diagnostic; imaging; tendinopathy
