MR Imaging of Abnormalities of the Plantar Fascia

Daphne J. Theodorou; Stavroula J. Theodorou; Donald Resnick

doi:10.1055/s-2002-32357

Seminars in Musculoskeletal Radiology, Table of Contents

Semin Musculoskelet Radiol 2002; 06(2): 105-118
DOI: 10.1055/s-2002-32357

MR Imaging of Abnormalities of the Plantar Fascia

Daphne J. Theodorou, Stavroula J. Theodorou, Donald Resnick

Department of Radiology, School of Medicine, University of California San Diego, San Diego, CA and Department of Radiology, Veterans Administration Medicial Center; San Diego, CA

Abstract

ABSTRACT

Foot pain and disability may curtail the performance of simple routine tasks, work-related duties, and athletic activities. Disorders of the plantar fascia are commonly encountered in the diagnostic evaluation of subcalcaneal heel pain. The approach to imaging the ankle and foot has undergone significant amendment with the introduction of magnetic resonance (MR) imaging. MR imaging allows direct visualization of the plantar fascia and permits a comprehensive evaluation of a wide spectrum of disorders involving the fascia and perifascial structures, including bones, ligaments, musculotendinous units, and intrinsic muscles of the foot. The objectives of our cadaveric and clinical study are to describe the normal MR imaging appearance of the plantar fascia and analyze the signal intensity changes in the fascia and perifascial tissue with conventional MR imaging in symptomatic patients. We present a brief overview of common disease processes involving the plantar fascia that may prove practical for routine imaging evaluation of patients with suspected pathology.

KEYWORDS

Plantar fascia - magnetic resonance imaging - foot

Full Text

References

REFERENCES

1 Theodorou D J, Theodorou S J, Resnick D. Special imaging studies. In: Bernstein J, Hart R, eds. Musculoskeletal Medicine Rosemont, IL: American Academy of Orthopedic Surgeons; 2003 In: press
2 McEnery K, Murphy W. Magnetic resonance imaging. In: Resnick D, ed. Bone and Joint Imaging Philadelphia: WB Saunders 1996: 84-93
3 Farooki S, Theodorou D J, Sokoloff R, Theodorou S J, Trudell D, Resnick R. MRI of the medial and lateral plantar nerves. J Comput Assist Tomogr . 2001; 25 412-416
4 Farooki S, Sokoloff R, Theodorou D J, Trudell D, Resnick D. MR imaging of the midfoot: normal anatomy with cadaveric correlation. Magn Reson Imaging Clin N Am . 2001; 9 419-434
5 Lektrakul N, Chung C, Lai Y. Tarsal sinus: arthrographic, MR imaging, MR arthrographic, and pathologic findings in cadavers and retrospective study data in patients with sinus tarsi syndrome. Radiology . 2001; 219 802-810
6 Sarrafian S. Plantar aponeurosis. In: Sarrafian S, ed. Anatomy of the Foot and Ankle: Descriptive, Topographic, Functional 2nd ed. Philadelphia: JB Lippincott 1993: 137-149
7 Thordarson D, Schmotzer H, Chon J, Peters J. Dynamic support of the human longitudinal arch: a biomechanical evaluation. Clin Orthop . 1995; 316 165-172
8 Sharkey N, Ferris L, Donahue S. Biomechanical consequences of plantar fascial release or rupture during gait: part I-disruptions in longitudinal arch conformation. Foot Ankle Int . 1998; 19 812-820
9 Sharkey N, Donahue S, Ferris L. Biomechanical consequences of plantar fascial release or rupture during gait: part II-alterations in forefoot loading. Foot Ankle Int . 1998; 19 812-820
10 Theodorou D J, Theodorou S J, Kakitsubata Y. Plantar fasciitis and fascial rupture: MR imaging findings in 26 patients supplemented with anatomic data in cadavers. Radiographics . 2000; 20 S181-S197
11 Theodorou D J, Theodorou S J, Farooki S, Kakitsubata Y, Resnick D. Disorders of the plantar aponeurosis: a spectrum of MR imaging findings. AJR Am J Roentgenol . 2001; 176 97-104
12 Theodorou D J, Theodorou S J, Lektrakul N, Gold G, Kakitsubata Y, Resnick D. Plantar fasciitis and fascial rupture: MR imaging in 25 patients with anatomic correlation in cadavers. Radiology (Suppl) . 1999; 213P 459
13 Theodorou D J, Theodorou S J, Resnick D. MR Imaging overview of disease processes affecting the plantar aponeurosis. Radiology (Suppl) . 2000; 217P 684
14 Resnick D. Abnormalities of the plantar soft tissues. In: Resnick D, ed. Diagnosis of Bone and Joint Disorders Philadelphia: WB Saunders 1995: 3204-3208
15 Berkowitz J, Kier R, Rudicel S. Plantar fasciitis: MR imaging. Radiology . 1991; 179 665-667
16 Lee T, Wapner K, Hecht P. Plantar fibromatosis. Current concepts review. J Bone Joint Surg Am . 1993; 75A 1080-1083
17 Straub H. Die elastischen fasern in der bandern des mensshlichen fusses. Acta Anat 1950-. 1951; 11 268-289
18 Warwick R, Williams P. In: Warwick R Williams P eds. Gray's Anatomy 35th British ed. Philadelphia: WB Saunders 1973: 579-580
19 Henkel A. Die aponeurosis plantaris. Arch für Anat und Physio Anat Abt . 1913; 113 113-123
20 Bojsen-Møller F, Flagstad K. Plantar aponeurosis and internal architecture of the ball of the foot. J Anat . 1976; 121 599-611
21 Agoada D. Aponeurosis, deep fascia and compartments of the foot. In: Marcinko D, ed. Medical and Surgical Therapeutics of the Foot and Ankle 1st ed. Baltimore, MD: Williams Wilkins 1992: 327-329
22 Grodinsky M. A study of the fascial spaces of the foot and their bearing on infections. Surg Gynecol Obstet . 1929; 49 737
23 Loth E. Étude anthropologique sur l'aponévrose plantaire. Bull Mem Soc Anthro Paris . 1913; 4 601
24 Loth E. Die plantar aponeurose beim menschen und den übrigen primaten. Korr Bl Deutsch Anthrop Ges . 1907;
25 Karr S. Subcalcaneal heel pain. Orthop Clin North Am . 1994; 25 161-175
26 Bordelon R L. Plantar fasciitis associated with pain in medial tuberosity (heel spur-subcalcaneal pain syndrome). In: DeLee J, Drez D, eds. Orthopaedic Sports Medicine: Principles and Practice 1st ed. Philadelphia: WB Saunders 1994: 1815-1830
27 Sarrafian S. Posterior tibial nerve. In: Sarrafian S, ed. Anatomy of the Foot and Ankle: Descriptive, Topographic, Functional 2nd ed. Philadelphia: JB Lippincott 1993: 365-390
28 Sarrafian S. The foot as a functional unit. In: Sarrafian S, ed. Anatomy of the Foot and Ankle: Descriptive, Topographic, Functional 2nd ed. Philadelphia: JB Lippincott 1993: 539-602
29 Hicks J. The mechanics of the foot: the plantar aponeurosis and the arch. J Anat . 1954; 88 25-31
30 DiMarcangelo M, Yu T. Diagnostic imaging of heel pain and plantar fasciitis. Clin Podiatric Med Surg . 1997; 14 281-301
31 Kier R. Magnetic resonance imaging of plantar fasciitis and other causes of heel pain. MRI Clin North Am . 1994; 2 97-107
32 Morrison W, Schweitzer M, Wapner K. Plantar fibromatosis: a benign aggressive neoplasm with a characteristic appearance on MR images. Radiology . 1994; 193 841-845
33 DeMaio M, Paine R, Mangine R. Plantar fasciitis. Orthopedics . 1993; 16 1153-1163
34 Hall R, Erickson S, Shereff M. Magnetic resonance imaging in the evaluation of heel pain. Orthopedics . 1996; 19 225-229
35 Kwong P, Kay D, Voner R. Plantar fasciitis: mechanics and pathomechanics of treatment. Clin Sports Med . 1988; 7 119-126
36 Grasel R, Schweitzer M, Kovalovich A. MR imaging of plantar fasciitis: edema, tears, and occult marrow abnormalities correlated with outcome. AJR Am J Roentgenol . 1999; 173 699-701
37 Leach R, Seavey M, Salter D. Results of surgery in athletes with plantar fasciitis. Foot Ankle . 1986; 7 156-161
38 Snider M, Clancy W, McBeath A. Plantar fascia release for chronic plantar fasciitis in runners. Am J Sports Med . 1983; 11 215-219
39 Rubin G, Witten M. Plantar calcaneal spurs. Am J Orthop . 1963; 5 38-41
40 Sebes J. The significance of calcaneal spurs in rheumatic diseases. Arthritis Rheum . 1989; 32 338-340
41 Schepsis A, Leach R, Gorzyca J. Plantar fasciitis: etiology, treatment, surgical results, and review of the literature. Clin Orthop . 1991; 266 185-196
42 Theodorou D J, Theodorou S J, Kakitsubata Y, Sartoris D, Resnick D. Imaging characteristics and epidemiologic features of atypical mycobacterial infections involving the musculoskeletal system. AJR Am J Roentgenol . 2001; 176 341-349
43 Smith A, Daniels T, Bohnen J. Soft-tissue infections and the diabetic foot. Am J Surg . 1996; 172 7S-12S
44 Theodorou D J, Theodorou S J, Resnick D. Magnetic resonance imaging of pyogenic myositis: a variety of findings. Radiology . 2001; 221P 667
45 Rahmouni A. MR imaging in acute infectious cellulitis. Radiology . 1994; 192 493-496
46 Kaye B, Kaye P, Bobrove A. Rheumatoid nodules. Am J Med . 1984; 76 279-292
47 Resnick D, Niwayama G. Rheumatoid arthritis. In: Resnick D, ed. Diagnosis of Bone and Joint Disorders Philadelphia: WB Saunders 1995: 866-970
48 Theodorou D J, Theodorou S J, Resnick D. Imaging of rheumatoid arthritis. In: Hochberg M, Silman A, Smolen J, Weinblatt M, Weisman M, eds. Rheumatology 3rd ed. London: Harcourt Publishers, Mosby; 2002
49 Winalski C, Palmer W, Rosenthal D. Magnetic resonance imaging of rheumatoid arthritis. Radiol Clin North Am . 1996; 34 243-258
50 Sanders T, Linares R, Su A. Rheumatoid nodule of the foot: MRI appearances mimicking an indeterminate soft-tissue mass. Skeletal Radiol . 1998; 27 457-460
51 Theodorou D J, Theodorou S J, Resnick D. The many faces of rheumatoid arthritis: emphasis on advanced imaging. Radiology . 2001; 221P 667
52 Leach R, Jones R, Silva T. Rupture of the plantar fascia in athletes. J Bone Joint Surg . 1978; 60 537-539
53 Acevedo J, Beskin J. Complications of plantar fascia rupture associated with corticosteroid injection. Foot Ankle Int . 1998; 19 91-97
54 Pai V. Rupture of the plantar fascia. J Foot Ankle Surg . 1996; 35 39-40
55 Herrick R, Herrick S. Rupture of the plantar fascia in a middle-aged tennis player. Am J Sports Med . 1983; 11 95
56 Ahstrom J. Spontaneous rupture of the plantar fascia. Am J Sports Med . 1988; 16 306-307
57 Sellman J. Plantar fascia rupture associated with corticosteroid injection. Foot Ankle Int . 1994; 15 376-381
58 Rolf C, Guntner P. Plantar fascia rupture: diagnosis and treatment. J Foot Ankle Surg . 1997; 36 112-114
59 Kransdorf M, Murphey M. Fibrous tumors. In: Kransdorf M, Murphey M, eds. Imaging of Soft-Tissue Tumors Philadelphia: WB Saunders 1997: 143-186
60 Lee T, Wapner K, Hecht P. Plantar fibromatosis. Current concepts review. J Bone Joint Surg Am . 1993; 75A 1080-1083
61 Theodorou D J, Theodorou S J, Kakitsubata Y, Farooki S, Botte M, Resnick D. Pathogenesis of fractures of the proximal fifth metatarsal bone: anatomic and imaging evidence indicative of avulsion of the plantar aponeurosis and the peroneus brevis tendon. Radiology . 2001; 221P S434
62 Theodorou D J, Theodorou S J, Kakitsubata Y, Botte M, D'Lima D, Resnick D. Fractures of the proximal fifth metatarsal bone: distinctive types. AJR Am J Roentgenol . 2000; 174(suppl) 116
63 Theodorou D J, Theodorou S J, Kakitsubata Y, Botte M, Resnick D. Pathogenesis of fractures of the proximal fifth metatarsal bone: anatomic and imaging evidence indicating avulsion of the plantar aponeurosis and the peroneus brevis tendon (in press). Radiology.