As fascia is variably defined, there can be confusion as to what constitutes fasciitis. Patients with chronic planter fasciitis treated with … Magnetic resonance imaging (MRI) is a further possible investigation to perform in difficult cases and is useful in detecting tears or ruptures of the fascia. The plantar fascia originates from the medial calcaneal tuberosity and splits into five bands that insert onto each of the proximal phalanges. 36, No. Note calcaneal spur (curved arrow), ill-defined calcaneal bone marrow edema (#), diffuse soft-tissue edema superficial to origin of plantar fascia (*), and hyperintense signal within plantar fascia close to its origin (straight arrow). Check the positioning block in the other two planes. Plantar fasciitis is a condition in which ruptures of this area occur due to flexing or over-extending any area of the connecting plantar tissue. In another study published online in February 2015 in the Journal of Vascular and Interventional Radiology, radiologists in Nebraska determined that ultrasonic therapy brought relief to 90 percent of patients with chronic plantar fasciitis. Figure 3a: Thickening and increased signal intensity of plantar fascia (open arrow) of right hindfoot in 45-year-old asymptomatic female volunteer. In addition to the clinical examination, US and MR imaging are useful modalities for diagnosing plantar fasciitis (5,11–13). All MR examinations were performed with use of a 1.5-T unit (Symphony; Siemens Medical Solutions, Erlangen, Germany) and a dedicated circular polarized transmit-receive extremity coil (one channel) with the subject in the supine position. Thus, the purpose of our study was to determine the spectrum of MR imaging findings at the calcaneal attachment of the plantar fascia in asymptomatic volunteers. They can, however, be very valuable in ruling out or confirming a stress fracture. This tissue band is elastic in nature and helps to support the arch and bones of the foot. Hold for 15 to 30 seconds. ; clinical studies, C.E., M.M., B.M., C.W.A.P. Figure 4: Sagittal MR image obtained with STIR sequence through plantar fascia in same asymptomatic volunteer as in Figure 3. Figure 6: Sagittal MR image obtained with STIR sequence at level of origin of plantar fascia in left hindfoot of 61-year-old asymptomatic volunteer shows example of slightly hyperintense signal within plantar fascia close to its origin (arrow) and a small amount of diffuse soft-tissue edema superficial to plantar fascia (*). Check the positioning block in the other two planes. Note calcaneal spur (curved arrow) at origin of plantar fascia. Stand on a bottom step and place the ball of your foot on the edge of the step. We also excluded subjects who had previously undergone foot surgery, those who had previously gone to a doctor because of foot complaints, those with a history of ankle trauma in the past 2 years, and those with systemic inflammatory disease or any medical disorders (eg, diabetes or metabolic disorder). (a) Coronal T1-weighted MR image close to origin of plantar fascia shows thickening and hyperintense signal within plantar fascia. Differences in thickness of the plantar fascia as determined by readers 1 and 2 were assessed with a paired t test. However, US is highly operator-dependent and cannot depict associated changes like calcaneal bone marrow edema (5,11–13). > We obtained follow-up data in 56 volunteers. (b) Coronal T1-weighted MR image obtained 1 cm distal to a. The Journal of Foot and Ankle Surgery, Vol. An appropriate angle must be given in the sagittal plane (parallel to the tibia). Sutera et al (5) noted that bone spurs were not found in healthy individuals but were found in 47% of symptomatic patients. ... Hamill, J. Since the tissue is fascia in nature, the imaging is directly similar to imaging of the plantar fascia and fasciitis. 0 = no hyperintense signal, 1 = hyperintense signal. The MR imaging findings in our group of asymptomatic volunteers contradict these earlier results. osteomyelitis) The paradigm is changing as scientific evidence challenges traditional heel pain treatment. Pain is also frequently brought on by bending the foot and toes up towards the shin. Numbers in parentheses are the range. If possible provide a chaperone for claustrophobic patients (e.g. MRI scanning is painless and does not involve X-ray radiation.