Plantar fasciitis - MSK Radiology Imaging Findings: • Thickening of the plantar fascia central band (measuring 9mm) with intrinsic T 2-hyperintense signal and perifascial "edema-like" signal. • Linear T2-hyperintense intrinsic fluid-like signal on the Sagittal STIR is consistent with a small interstitial tear of the central fascicle. Case description: • Most commonly involves central band of the fascia (superficial to flexor digitorum brevis). • Plain film: Not specific. Heel spur often seen in asymptomatic patients. Can see fascial thickening. • Ultrasound: >4.5mm thickness and hypoechoic fascia. • MRI: T1/PD intermediate signal, T2 hyperintense signal, STIR is most sensitive to edema. Perifascial edema and reactive marrow edema of the calcaneus can also be seen. Differential diagnosis: • Plantar fibromatosis: Nodular thickening of fascia and usually more distal. • Plantar fascia tear: Discontinuity of the fascia usually due to injury or from steroid injection. • Plantar heel pad fibrosis: Within the subcutaneous fat in the heel pad, elderly, diabetics. Dr. Donald von Borstel @DrvonBorstel #Heel #Plantar #fasciitis #clinical #mri #clinical #Radiology #diagnosis #msk
