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Ultrasound
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Musculoskeletal
Soft Tissue and Bone Tumors
Plantar Fasciitis and Fibromatosis
Plantar Fasciitis and Fibromatosis
Ryan K. L. Lee, MBChB, FRCR, FHKAM (Radiology); James F. Griffith, MD, MRCP, FRCR
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KEY FACTS

  • Terminology

    • Imaging

      • Diagnostic Checklist

        TERMINOLOGY

        • Synonyms

          • Plantar fasciitis: Jogger's heel, tennis heel, policeman's heel, heel spur syndrome, calcaneal spur syndrome, plantar fasciopathy
          • Plantar fibromatosis: Ledderhose disease, plantar fibroma

        • Definitions

          • Plantar fascia = multilayered fibrous aponeurosis, 1-2 mm thick, with medial, central, and lateral bands
            • Supports long and short plantar ligaments in maintaining longitudinal arches of foot
              • Innervated by medial calcaneal nerve and 1st branch lateral plantar nerve
                • Entrapment of 1st branch lateral plantar nerve (Baxter neuropathy) can simulate plantar fasciitis
            • Medial band is least significant
              • Inserts into 1st metatarsophalangeal joint
            • Central band is largest; originates from medial tuberosity of calcaneum
              • Divides in forefoot into 5 bands that insert onto plantar plates of metatarsophalangeal joints 
            • Lateral band inserts into base of 5th metatarsal bone
          • Plantar fasciitis: Degeneration ± fibroblastic proliferation of plantar fascia insertion to medial tuberosity of calcaneus
            • As there is no clear inflammatory component, plantar fasciopathy may be more favorable term
          • Plantar fibromatosis: Nodular fibroblastic proliferation of plantar fascia separate from calcaneus

        IMAGING

        • General Features

          • Radiographic Findings

            • MR Findings

              • Ultrasonographic Findings

                • Imaging Recommendations

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      • Gross Pathologic & Surgical Features

                        • Microscopic Features

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Natural History & Prognosis

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Consider

                                    • Image Interpretation Pearls

                                      Selected References

                                      1. Draghi F et al: Imaging of plantar fascia disorders: findings on plain radiography, ultrasound and magnetic resonance imaging. Insights Imaging. 8(1):69-78, 2017
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Diagnostic Checklist

                                            TERMINOLOGY

                                            • Synonyms

                                              • Plantar fasciitis: Jogger's heel, tennis heel, policeman's heel, heel spur syndrome, calcaneal spur syndrome, plantar fasciopathy
                                              • Plantar fibromatosis: Ledderhose disease, plantar fibroma

                                            • Definitions

                                              • Plantar fascia = multilayered fibrous aponeurosis, 1-2 mm thick, with medial, central, and lateral bands
                                                • Supports long and short plantar ligaments in maintaining longitudinal arches of foot
                                                  • Innervated by medial calcaneal nerve and 1st branch lateral plantar nerve
                                                    • Entrapment of 1st branch lateral plantar nerve (Baxter neuropathy) can simulate plantar fasciitis
                                                • Medial band is least significant
                                                  • Inserts into 1st metatarsophalangeal joint
                                                • Central band is largest; originates from medial tuberosity of calcaneum
                                                  • Divides in forefoot into 5 bands that insert onto plantar plates of metatarsophalangeal joints 
                                                • Lateral band inserts into base of 5th metatarsal bone
                                              • Plantar fasciitis: Degeneration ± fibroblastic proliferation of plantar fascia insertion to medial tuberosity of calcaneus
                                                • As there is no clear inflammatory component, plantar fasciopathy may be more favorable term
                                              • Plantar fibromatosis: Nodular fibroblastic proliferation of plantar fascia separate from calcaneus

                                            IMAGING

                                            • General Features

                                              • Radiographic Findings

                                                • MR Findings

                                                  • Ultrasonographic Findings

                                                    • Imaging Recommendations

                                                      DIFFERENTIAL DIAGNOSIS

                                                        PATHOLOGY

                                                        • General Features

                                                          • Gross Pathologic & Surgical Features

                                                            • Microscopic Features

                                                              CLINICAL ISSUES

                                                              • Presentation

                                                                • Demographics

                                                                  • Natural History & Prognosis

                                                                    • Treatment

                                                                      DIAGNOSTIC CHECKLIST

                                                                      • Consider

                                                                        • Image Interpretation Pearls

                                                                          Selected References

                                                                          1. Draghi F et al: Imaging of plantar fascia disorders: findings on plain radiography, ultrasound and magnetic resonance imaging. Insights Imaging. 8(1):69-78, 2017