Plantar fascia: imaging diagnosis and guided treatment

Semin Musculoskelet Radiol. 2010 Sep;14(3):334-43. doi: 10.1055/s-0030-1254522. Epub 2010 Jun 10.

Abstract

Plantar fasciopathy is a common cause of heel pain. This article covers the imaging anatomy of the hindfoot, the imaging findings on ultrasound and magnetic resonance imaging (MRI) of plantar fasciopathy, plantar fibromas, trauma, Achilles tendonopathy, neural compression, stress fractures of the os calcis and other heel pad lesions. Thickening of the plantar fascia insertion more than 5 mm either on ultrasound or MRI is suggestive of plantar fasciopathy. Ultrasound is superior to MRI for diagnosis of plantar fibroma as small low signal lesions on MRI are similar to the normal plantar fascia signal. Ultrasound demonstrates low echogenicity compared with the echogenic plantar fascia. Penetrating injuries can appear bizarre due to associated foreign body impaction and infection. Achilles tendonopathy can cause heel pain and should be considered as a possible diagnosis. Treatment options include physical therapy, ECSWT, corticosteroid injection, and dry needling. Percutaneous US guided treatment methods will be described.

Publication types

  • Review

MeSH terms

  • Biomechanical Phenomena
  • Bone Neoplasms / diagnosis*
  • Bone Neoplasms / therapy
  • Diagnosis, Differential
  • Fascia / diagnostic imaging
  • Fascia / injuries
  • Fascia / pathology
  • Fasciitis, Plantar / diagnosis*
  • Fasciitis, Plantar / therapy*
  • Fibroma / diagnosis*
  • Fibroma / therapy
  • Foot Diseases / diagnosis
  • Foot Diseases / therapy
  • Heel / diagnostic imaging*
  • Heel / innervation
  • Heel / pathology*
  • Humans
  • Magnetic Resonance Imaging
  • Nerve Compression Syndromes / diagnosis
  • Nerve Compression Syndromes / therapy
  • Pain / etiology
  • Pain Management
  • Tendinopathy / diagnosis
  • Tendinopathy / therapy
  • Ultrasonography