Precision X-ray diagnostics of the effectiveness of extracorporeal shock wave therapy of heel spurs

Introduction. The relevance of the study is due to the high prevalence of degenerative-dystrophic changes and diseases of the musculoskeletal system in the structure of diseases in the general population and among people working in contact with harmful industrial factors, i.e. it can be a pathology to a large extent and professionally caused.

The study aims to optimize the X–ray diagnosis of heel spurs based on the use of sharp-focus digital radiography and a set of methodological techniques for posteriori radiometry (radiography and X-ray densitometry).

Materials and methods. The authors analyzed the results of clinical and X-ray examination of 135 miners (men) of the treatment faces: 65 people were patients with insertion endopathy, calcifications in the area of attachment of the plantar fascia (plantar heel spur) and Achilles tendon to the calcaneus (dorsal heel spur). The control group consisted of 70 people without clinical manifestations and instrumentally detectable signs of multifocal accumulation of calcium phosphate crystals in the periossal tissues of the feet. The specialist performed all measurements using Dr. LINS Machaon's workstation. The scientists evaluated the data at the initial stage of the study, before the use of therapy, immediately after treatment (3 months after the start and 12 months after the final session of extracorporeal shock wave therapy (SWT) using a piezo wave device (Richard Wolf, Austria), i.e. in dynamics according to the phases of rest, resorption and recovery.

Results. The use of a complex of modern medical technologies in the aspect of solving the problem of improving the diagnosis of heel spurs made it possible to objectify the intensity of disintegration processes in the process of evaluating the effectiveness of extracorporeal shock wave therapy at its various stages in the dynamics of observations.

Limitations. Numerical limitations and relatively large distance of patients (Eastern Siberia) from the site of in-depth examination (Moscow).

Conclusion. The use of digital diagnostic radiography in the acute focus mode followed by a posteriori rengenometry using the capabilities of research software expands the prospects for obtaining sufficiently objective radiometric (X-ray and X-ray densitometric) information (including from the working population in outpatient settings) without involving additional, expensive and not always available hardware diagnostics using CT and MRI. Radiometric parameters in assessing the condition of the periosteal soft tissue structures of the calcaneus and the phenomenon of calcinate decay in the areas of interest open up a real opportunity to accurately assess the effectiveness of the physiotherapeutic SWT method of heel spurs.

Ethics. The study did not require the conclusion of an Ethics Committee.

Contributions:
Druzhinin V.N. — research concept and design, data collection, text writing;
Suvorov V.G. — data collection and processing;
Slavinsky A.A. — editing;
Troynyakov S.N. — statistical analysis.

Funding. The study had no funding.

Conflict of interest. The authors declare no conflict of interest.

Received: 24.04.2025 / Accepted: 30.05.2025 / Published: 05.07.2025

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