Imaging

Plantar Fasciitis

Preliminary Diagnosis: Plantar Fasciitis

I. What imaging technique is first-line for this diagnosis?

MRI of the foot without contrast

II. Describe the advantages and disadvantages of this technique for diagnosing plantar fasciitis.

Advantages

  • Diagnostic modality to evaluate the anatomy of the plantar fascia, including the medial, central, and lateral cords.

  • Diagnostic modality to evaluate for fascial tears, perifascial muscle/soft tissue edema, or osseous edema at the calcaneal enthesal attachment.

  • Does not use ionizing radiation.

Disadvantages

  • Expensive.

  • Time consuming.

  • Requires significant patient cooperation to minimize motion artifact.

III. What are the contraindications for the first-line imaging technique?

Contraindications include a non-MR compatible hardware.

IV. What alternative imaging techniques are available?

An alternative is ultrasound of the plantar fascia using a high frequency linear transducer with Color Doppler interrogation.

V. Describe the advantages and disadvantages of the alternative techniques for diagnosing plantar fasciitis.

Ultrasound of the plantar fascia using a high frequency linear transducer with Color Doppler interrogation

Advantages

  • Inexpensive.

  • Provides a dynamic assessment.

  • Can compare both lower extremities.

  • Can use color doppler to evaluate for hyperemia.

  • Provides a quick evaluation.

  • Highly portable.

Disadvantages

  • Operator dependent (need a skilled sonographer).

VI. What are the contraindications for the alternative imaging techniques?

There are no significant contraindications for ultrasound of the plantar fascia using a high frequency linear transducer with Color Doppler interrogation.

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