The Role of Medical Imaging in Diagnosing and Monitoring Plantar Fasciitis

Plantar fasciitis is a prevalent condition characterized by heel pain, which can occur in individuals from all walks of life. The primary cause of this condition is the repetitive strain placed on the plantar fascia, a band of tissue located along the underside of the foot. This tissue spans from the heel to the toes and plays a crucial role in providing support and maintaining the arch of the foot.

Heel pain is a common sensation that is often felt in the heel area, although it can also occur in the arch of the foot. This discomfort is often intensified when standing or running for long durations.

Symptoms

Plantar fasciitis is a common foot condition characterized by pain on the underside of the foot, specifically near or at the heel. This discomfort is often likened to the sensation of a bruise caused by a stone. The symptoms of plantar fasciitis are usually more severe during the morning hours and after prolonged periods of sitting.

It is often due to tight calf muscles pulling on the tissue band that runs from your heel to your toes, but it can also be caused by sudden increases in weight or biomechanical problems with your feet that put undue strain on the tissue.

Treatments for plantar fasciitis may include resting the affected foot, applying ice packs, taking nonsteroidal anti-inflammatory drugs (NSAIDs), and wearing shoes with arch supports and padding. Avoiding impact exercises like running may also reduce pain.

Diagnosis

The plantar fascia is a band of tissue running along the bottom of your foot, connecting your heel bone (calcaneus) to the base of your toes. It absorbs shock when you walk and keeps your arch supported.

Heel pain is the most common source of heel discomfort. Typically, you will experience a stabbing or tearing sensation that feels like a bruise on the bottom foot.

Untreated diabetes can become chronic, meaning your foot gets worse with time as the amount of stress placed upon it continues to exacerbate.

You may be able to reduce your pain at home with over-the-counter ibuprofen or anti-inflammatory drugs. However, if those don’t work, your doctor may suggest an injection of corticosteroid directly into the damaged part of the plantar fascia.

Your doctor may suggest getting X-rays to ensure the pain isn’t due to something else. An ultrasound scan can also detect any thickening or swelling in your plantar fascia.

Treatment

Treatment for plantar fasciitis includes rest, foot and arch support, nonsteroidal anti-inflammatory drugs (NSAIDs), icing your feet, stretching and physical therapy. On average, more than 90% of patients who start these simple treatments will see improvements within 10 months.

Imaging is often necessary to confirm the diagnosis and rule out other causes of heel pain. Plain radiography, ultrasound and magnetic resonance imaging (MRI) may demonstrate thickening of the plantar fascia (PF), loss of fibrillar structure, perifascial collections and calcifications in patients with plantar fasciitis [7, 8].

Medical imaging should be considered in patients with suspected atypical plantar fasciitis, symptoms or recalcitrant heel pain who are not responding to appropriate treatment. Other conditions that may have similar MRI findings include calcaneal spurs, rheumatoid arthritis and Crohn’s disease, which may cause symptoms similar to plantar fasciitis but do not occur in most cases. They are more common among those who have a history of overuse or overpronation as this biomechanical risk factor for developing the condition.

Monitoring

Medical imaging is an invaluable asset in diagnosing and managing Plantar Fasciitis (PF). X-ray or magnetic resonance imaging (MRI) can help rule out any underlying skeletal issues that could be causing your heel pain.

Medical imaging can detect microtears and inflammation in the plantar fascia. Magnetic resonance imaging (MRI) may show signs of rupture of this ligament, which often occurs among athletes involved in running or jumping activities.

In a prospective trial, ultrasound-guided corticosteroid injection was compared to palpation-guided injection for treating idiopathic plantar fasciitis. Results revealed that ultrasound-guided injection significantly improved pain score (VAS) and Heel Tenderness Index (HTI) among those with symptoms in their heels, while palpation-guided injection did not.