This study evaluates the effectiveness of ultrasonography (US) and shear wave elastography (SWE) in diagnosing different causes of heel pain, using magnetic resonance imaging (MRI) as a comparison standard. The study included 55 heels, with a mean patient age of 38.3 years, comprising 10 control cases and 41 cases, four of which had bilateral heel pain. The sample group included 23 females (56.1%) and 18 males (43.95%). Both US and SWE examinations were performed in various positions to capture optimal imaging data, which was then correlated with MRI findings. Results showed that ultrasound provided high sensitivity and specificity for diagnosing heel pain. Notably, SWE demonstrated a strong correlation with MRI, significantly enhancing the diagnostic precision of ultrasound for early detection of conditions such as plantar fasciitis and Achilles tendinopathy. For plantar fasciitis, combining US with SWE improved diagnostic accuracy from 88.9% to 93.3%, with sensitivity reaching 100% and specificity at 83.3%. Similarly, for Achilles tendinopathy, accuracy improved from 88.9% to 97.8%, with a sensitivity of 94.7% and a specificity of 100%. These findings underscore the complementary role of SWE in supporting ultrasound diagnostics, particularly in early disease stages. Overall, this study highlights that ultrasound serves as an effective primary tool for diagnosing heel pain causes, while SWE adds value by improving diagnostic precision and correlating strongly with clinical outcomes. This combination allows for more accurate patient evaluation, aiding in both initial diagnosis and follow-up care. Thus, implementing both US and SWE can enhance clinical decision-making and improve outcomes for patients presenting with heel pain.
