Serum CTGF in Chronic Plantar Fasciitis

Association of Serum Connective Tissue Growth Factor (CTGF/CCN2) Levels With Pain and Functional Status in Patients With Chronic Plantar Fasciitis

This observational study aims to evaluate serum Connective Tissue Growth Factor (CTGF/CCN2) levels in patients with chronic plantar fasciitis compared with asymptomatic controls. The study will also assess the associations between serum CTGF levels and clinical and ultrasonographic characteristics of chronic plantar fasciitis.

This is a single-center observational study including patients with chronic plantar fasciitis and asymptomatic controls. Serum CTGF/CCN2 levels will be evaluated, and their associations with clinical and ultrasonographic characteristics will be assessed.

Inclusion Criteria:

• Age 18-65 years.
• Written informed consent.
• For the patient group: chronic plantar heel pain for at least 3 months, pain during the first steps in the morning or after prolonged rest, tenderness over the medial calcaneal tubercle, and clinical and ultrasonographic findings consistent with chronic plantar fasciitis.
• For the control group: asymptomatic individuals without a previous diagnosis or clinical and ultrasonographic findings of plantar fasciitis.

Exclusion Criteria:

• Tarsal tunnel syndrome, calcaneal stress fracture, plantar fascia rupture, Achilles tendinopathy, heel fat pad syndrome, plantar fibromatosis, or other foot conditions causing plantar heel pain.
• Diabetes mellitus.
• Inflammatory rheumatic diseases or gout.
• Chronic kidney or liver disease.
• Malignancy.
• Active infection or autoimmune disease
• Pregnancy.
• Previous foot or ankle surgery.
• Corticosteroid injection, platelet-rich plasma (PRP), prolotherapy, extracorporeal shock wave therapy (ESWT), or other interventional treatment to the affected heel within the previous 3 months.
• Serious systemic conditions that may affect serum CTGF/CCN2 levels.