Ultrasonics Methods and Applications

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4 Clegg DO, Reda DJ, Harris CL et al. Glucosamine, chondroitin sulphate, and the two in combination for painful knee osteoarthritis. New Engl J Med 2006; 354: 795–808. 5 Zochling J, March LM, Lapsley H, Cross M, Tribe K, Brooks P. Use of complementary medicines for osteoarthritis – a prospective study. Ann Rheum Dis 2004; 63: 549–54. 6 Bellamy N, Campbell J, Robinson V, Gee T, Bourne R, Wells G. Viscosupplementation for the treatment of osteoarthritis of the knee. Cochrane Database Syst Rev 2006; CD005321.

A pilot study of the effects of behavioural weight loss treatment on fibromyalgia symptoms. J Psychsom Res 2005; 59: 275–82. QXD 18/3/08 14:28 Page 33 07 Plantar fasciitis 33 P R O B L E M 07 Plantar Fasciitis Case History Shirley is aged 43 years and presents with exquisite pain beneath her left heel when walking. She is moderately obese (body mass index 32 kg/m2) and finds it hard to walk first thing in the morning. She prefers to wear open sandals. Should Shirley have X-rays to determine whether she has a plantar spur?

However, more widespread understanding and clearer definition, along with a more highly developed treatment flow, are beginning to streamline management and improve the outlook. There is a danger that over-enthusiastic investigation might contribute to making the condition more chronic. However, this should not deter the clinician from making a full investigation and the clinical picture warrants it. The major differential diagnosis is other connective tissue disorders, including rheumatoid disease, SLE and scleroderma.

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