AccScience Publishing / OTE / Online First / DOI: 10.36922/OTE025430019
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REVIEW ARTICLE

Diagnostic accuracy of ultrasound elastography for detecting plantar fasciitis: A systematic review and meta-analysis

Muhammad Moazzam1,2*
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1 Office of Research, Innovation, and Commercialization, Green International University, Lahore, Punjab, Pakistan
2 Department of Biomedical Engineering, School of Engineering and Digital Sciences, Nazarbayev University, Astana, Akmola Region, Kazakhstan
OTE, 025430019 https://doi.org/10.36922/OTE025430019
Received: 20 October 2025 | Revised: 3 December 2025 | Accepted: 4 January 2026 | Published online: 20 February 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Plantar fasciitis (PF) is a leading cause of heel pain in adults, resulting in significant discomfort and reduced mobility. Conventional imaging methods, such as B-mode ultrasonography and magnetic resonance imaging (MRI), mainly assess structural changes but do not capture biomechanical alterations in the plantar fascia. Ultrasound elastography (UE), including strain elastography and shear wave elastography (SWE), provides a noninvasive and quantitative assessment of tissue stiffness and may enhance diagnostic accuracy. This systematic review and meta-analysis evaluated the diagnostic performance of UE for PF. A comprehensive search of PubMed, Scopus, Web of Science, Embase, and the Cochrane Library identified studies published between January 2015 and September 2025. Eligible studies compared UE findings with clinical, ultrasonographic, or MRI-based reference standards. Fifteen studies met the inclusion criteria for the systematic review; nine provided sufficient data for quantitative synthesis, involving 913 participants (419 PF cases and 494 controls). The pooled sensitivity and specificity were 90.8% (95% confidence interval [CI]: 78.6–96.4) and 76.0% (95% CI: 66.4–83.5), respectively, with a diagnostic odds ratio of 31.38 (95% CI: 10.06–97.91). The positive and negative likelihood ratios were 3.78 and 0.12, indicating strong discriminatory ability. SWE, in particular, demonstrated high diagnostic value. Standardized imaging protocols and diagnostic thresholds are needed to support wider clinical adoption.

Graphical abstract
Keywords
Plantar fasciitis
Ultrasound elastography
Shear wave elastography
Strain elastography
Diagnostic accuracy
Ultrasound imaging
Funding
None.
Conflict of interest
The author declares no conflict of interest.
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