Download PDF
Semin Musculoskelet Radiol 2002; 06(2): 105-118
DOI: 10.1055/s-2002-32357
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

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
Further Information

Publication History

Publication Date:
20 June 2002 (online)

Also available at
    Permissions and Reprints

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

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
    Google Scholar
  • 2 McEnery K, Murphy W. Magnetic resonance imaging. In: Resnick D, ed. Bone and Joint Imaging Philadelphia: WB Saunders 1996: 84-93
    Google Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    Google Scholar
  • 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
    Google Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 13 Theodorou D J, Theodorou S J, Resnick D. MR Imaging overview of disease processes affecting the plantar aponeurosis.  Radiology (Suppl) . 2000;  217P 684
    PubMedGoogle Scholar
  • 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
    Google Scholar
  • 15 Berkowitz J, Kier R, Rudicel S. Plantar fasciitis: MR imaging.  Radiology . 1991;  179 665-667
    PubMedGoogle Scholar
  • 16 Lee T, Wapner K, Hecht P. Plantar fibromatosis. Current concepts review.  J Bone Joint Surg Am . 1993;  75A 1080-1083
    PubMedGoogle Scholar
  • 17 Straub H. Die elastischen fasern in der bandern des mensshlichen fusses.  Acta Anat 1950-. 1951;  11 268-289
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 20 Bojsen-Møller F, Flagstad K. Plantar aponeurosis and internal architecture of the ball of the foot.  J Anat . 1976;  121 599-611
    PubMedGoogle Scholar
  • 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
    Google Scholar
  • 22 Grodinsky M. A study of the fascial spaces of the foot and their bearing on infections.  Surg Gynecol Obstet . 1929;  49 737
    PubMedGoogle Scholar
  • 23 Loth E. Étude anthropologique sur l'aponévrose plantaire.  Bull Mem Soc Anthro Paris . 1913;  4 601
    PubMedGoogle Scholar
  • 24 Loth E. Die plantar aponeurose beim menschen und den übrigen primaten.  Korr Bl Deutsch Anthrop Ges . 1907; 
    PubMedGoogle Scholar
  • 25 Karr S. Subcalcaneal heel pain.  Orthop Clin North Am . 1994;  25 161-175
    PubMedGoogle Scholar
  • 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
    Google Scholar
  • 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
    Google Scholar
  • 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
    Google Scholar
  • 29 Hicks J. The mechanics of the foot: the plantar aponeurosis and the arch.  J Anat . 1954;  88 25-31
    PubMedGoogle Scholar
  • 30 DiMarcangelo M, Yu T. Diagnostic imaging of heel pain and plantar fasciitis.  Clin Podiatric Med Surg . 1997;  14 281-301
    PubMedGoogle Scholar
  • 31 Kier R. Magnetic resonance imaging of plantar fasciitis and other causes of heel pain.  MRI Clin North Am . 1994;  2 97-107
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 33 DeMaio M, Paine R, Mangine R. Plantar fasciitis.  Orthopedics . 1993;  16 1153-1163
    PubMedGoogle Scholar
  • 34 Hall R, Erickson S, Shereff M. Magnetic resonance imaging in the evaluation of heel pain.  Orthopedics . 1996;  19 225-229
    PubMedGoogle Scholar
  • 35 Kwong P, Kay D, Voner R. Plantar fasciitis: mechanics and pathomechanics of treatment.  Clin Sports Med . 1988;  7 119-126
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 37 Leach R, Seavey M, Salter D. Results of surgery in athletes with plantar fasciitis.  Foot Ankle . 1986;  7 156-161
    PubMedGoogle Scholar
  • 38 Snider M, Clancy W, McBeath A. Plantar fascia release for chronic plantar fasciitis in runners.  Am J Sports Med . 1983;  11 215-219
    PubMedGoogle Scholar
  • 39 Rubin G, Witten M. Plantar calcaneal spurs.  Am J Orthop . 1963;  5 38-41
    PubMedGoogle Scholar
  • 40 Sebes J. The significance of calcaneal spurs in rheumatic diseases.  Arthritis Rheum . 1989;  32 338-340
    PubMedGoogle Scholar
  • 41 Schepsis A, Leach R, Gorzyca J. Plantar fasciitis: etiology, treatment, surgical results, and review of the literature.  Clin Orthop . 1991;  266 185-196
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 43 Smith A, Daniels T, Bohnen J. Soft-tissue infections and the diabetic foot.  Am J Surg . 1996;  172 7S-12S
    CrossrefPubMedGoogle Scholar
  • 44 Theodorou D J, Theodorou S J, Resnick D. Magnetic resonance imaging of pyogenic myositis: a variety of findings.  Radiology . 2001;  221P 667
    PubMedGoogle Scholar
  • 45 Rahmouni A. MR imaging in acute infectious cellulitis.  Radiology . 1994;  192 493-496
    PubMedGoogle Scholar
  • 46 Kaye B, Kaye P, Bobrove A. Rheumatoid nodules.  Am J Med . 1984;  76 279-292
    CrossrefPubMedGoogle Scholar
  • 47 Resnick D, Niwayama G. Rheumatoid arthritis. In: Resnick D, ed. Diagnosis of Bone and Joint Disorders Philadelphia: WB Saunders 1995: 866-970
    Google Scholar
  • 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
    Google Scholar
  • 49 Winalski C, Palmer W, Rosenthal D. Magnetic resonance imaging of rheumatoid arthritis.  Radiol Clin North Am . 1996;  34 243-258
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 51 Theodorou D J, Theodorou S J, Resnick D. The many faces of rheumatoid arthritis: emphasis on advanced imaging.  Radiology . 2001;  221P 667
    PubMedGoogle Scholar
  • 52 Leach R, Jones R, Silva T. Rupture of the plantar fascia in athletes.  J Bone Joint Surg . 1978;  60 537-539
    PubMedGoogle Scholar
  • 53 Acevedo J, Beskin J. Complications of plantar fascia rupture associated with corticosteroid injection.  Foot Ankle Int . 1998;  19 91-97
    PubMedGoogle Scholar
  • 54 Pai V. Rupture of the plantar fascia.  J Foot Ankle Surg . 1996;  35 39-40
    PubMedGoogle Scholar
  • 55 Herrick R, Herrick S. Rupture of the plantar fascia in a middle-aged tennis player.  Am J Sports Med . 1983;  11 95
    PubMedGoogle Scholar
  • 56 Ahstrom J. Spontaneous rupture of the plantar fascia.  Am J Sports Med . 1988;  16 306-307
    PubMedGoogle Scholar
  • 57 Sellman J. Plantar fascia rupture associated with corticosteroid injection.  Foot Ankle Int . 1994;  15 376-381
    PubMedGoogle Scholar
  • 58 Rolf C, Guntner P. Plantar fascia rupture: diagnosis and treatment.  J Foot Ankle Surg . 1997;  36 112-114
    PubMedGoogle Scholar
  • 59 Kransdorf M, Murphey M. Fibrous tumors. In: Kransdorf M, Murphey M, eds. Imaging of Soft-Tissue Tumors Philadelphia: WB Saunders 1997: 143-186
    Google Scholar
  • 60 Lee T, Wapner K, Hecht P. Plantar fibromatosis. Current concepts review.  J Bone Joint Surg Am . 1993;  75A 1080-1083
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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.
    PubMedGoogle Scholar
      >