Discussion of Plantar fasciitis
- Plantar fasciitis is the most common cause of plantar heel pain.
- Can arise either from the stress of repetitive trauma or as an enthesopathy in association with seronegative spondyloarthropathies (ankylosing spondylitis, Reiter's syndrome, psoriatic arthritis).
- The stress-related form of plantar fasciitis is more common and generally occurs in obese middle-aged or elderly patients as a result of repetitive trauma from athletic activities, excessive job-related standing and walking, changes in walking surfaces, or changes in shoewear. It may also occur in young persons who engage in sports activities that involve running or jumping.
- Pain on the undersurface of the heel on weight bearing is the principal complaint.
- The pain is often worse when weight is borne after a period of rest (eg, in the morning) and eases with walking.
- Treatment is conservative and consists of weight reduction in obese patients, rest, nonsteroidal antiinflammatory drug therapy, local steroid injection, and reduction of weight-bearing pressure
- Surgical treatment of plantar fasciitis is reserved for cases in which conservative treatment fails.
 Imaging Findings for Plantar fasciitis
- Radiography may reveal a plantar calcaneal spur, although this entity may also be observed in asymptomatic adults.
- MR imaging characteristics of plantar fasciitis include:
- Fascial thickening that is often fusiform and typically involves the proximal portion and extends to the calcaneal insertion
- Increased signal intensity of the proximal plantar fascia
- Other MR imaging findings that indicate plantar fasciitis include edema of the adjacent fat pad and underlying soft tissues and limited marrow edema within the medial calcaneal tuberosity
- STIR MR imaging is often the most sensitive in the detection of both fascial and perifascial edema, which appear as poorly marginated areas of high signal intensity.
Patient #1: MR images demonstrate plantar fascitis
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 References for Plantar fasciitis
- José A. Narváez, Javier Narváez, Raúl Ortega, Carlos Aguilera, Ana Sánchez, and Eduard Andía. Painful Heel: MR Imaging Findings. RadioGraphics 2000 20: 333-352.