الفهرس 
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Abstract
Background:
Plantar fasciitis is the most common cause of hind foot pain. Treatment is aimed at pain reduction and maintaining or improving function. Several types of injected materials are used including corticosteroids, hyaluronic acid and Platelet-rich plasma.
Aim of the work:
The aim of this study was to evaluate the efficacy and safety of hyaluronic acid injection in comparison with corticosteroid injection for the treatment of degenerative plantar fasciitis.
Methods:
This study included forty patients with degenerative plantar fasciitis diagnosed according to clinical examination and ultrasound findings. They were divided into two groups. group one included twenty patients who were injected with Methylprednisolone (MP). group two included another twenty patients who were injected with hyaluronic acid (HA). Clinical assessment was done including morning heel pain, localized heel tenderness, patient assessment of heel pain using the numerical rating scale (NRS), Functional assessment using the Manchester-Oxford foot questionnaire (MOXFQ) and musculoskeletal ultrasound assessment including plantar fascia thickness, echogenicity, power Doppler signals, erosions and calcification.
Patients were injected and a follow up was done at two and six weeks for each group.
Results:
The two groups MP and HA showed no significant baseline differences in clinical and sonographic variables, while they both significantly improved from baseline after two and six weeks of injection (P<0.001). The MP group achieved significant improvements in NRS, MOXFQ, plantar fascial thickness and echogenicity in the first follow up after two weeks better than the second follow up after six weeks (P<0.001). The HA group achieved significant improvements in NRS, MOXFQ, plantar fascial thickness and echogenicity in the second follow up after six weeks better than the first follow up after two weeks (P<0.001).
Over all, MP group had more signifcant improvement clinically and sonographically than HA group after two weeks (P<0.001), while HA group had signifcant improvement clinically and sonographically in comparison with MP group after six weeks (P<0.001).
Conclusion: Our study supports the use of a single injection of hyaluronic acid as therapy for plantar fasciitis in preference to methylprednisolone acetate injections. While MP offers short term improvement (after two weeks), HA injection offers better therapeutic advantages in the intermediate-term follow up (after six weeks). Moreover, it has a longer duration of action and enables better tissue healing and can therefore be used as an effective alternative treatment for plantar fasciitis.