Plantar Fasciitis and Fibromatosis
KEY FACTS
Terminology
Imaging
- • Plantar fasciitis
Thickened plantar fascial insertion, especially at medial aspect of calcaneum
Plantar fascia thickness > 4.5 mm (most useful sign)
± hypoechogenicity of plantar fascia
± decreased fascial definition
± perifascial edema
± edema, disruption, and atrophy of heel fat pad
Spur is located deep to (and not within) fascia
Bilateral in 1/3
Subclinical disease on opposite side is not uncommon so do not use opposite side as internal normal reference
- • Plantar fibromatosis
Discrete fusiform-shaped nodule of plantar fascia separated from calcaneal insertion
Hypoechoic (75%) or isoechoic (25%) to plantar fascia
Posterior acoustic enhancement (40%) or shadowing (20%)
Intrinsic vascularity (10%)
Majority are located within central or medial bands of plantar fascia
Bilateral in 1/3 and multiple on symptomatic side in 1/4














TERMINOLOGY
Synonyms
Definitions
- • Plantar fascia = multilayered fibrous aponeurosis, 1-2 mm thick, with medial, central, and lateral bands
- • Plantar fasciitis: Degeneration ± fibroblastic proliferation of plantar fascia insertion to medial tuberosity of calcaneus
- • Plantar fibromatosis: Nodular fibroblastic proliferation of plantar fascia separate from calcaneus
IMAGING
General Features
Ultrasonographic Findings
- • Plantar fasciitis
- • Plantar fibromatosis
Discrete fusiform-shaped nodule of plantar fascia separated from calcaneal insertion
Hypoechoic (75%) or isoechoic (25%) to plantar fascia
Posterior acoustic enhancement (40%) or shadowing (20%)
Intrinsic vascularity (5%)
Majority are located within midsubstance or superficial aspect of plantar fascia
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