Ultrasound of the Month – Case 87
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Ultrasound of the Month – Case 87
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Ultrasound of the Month – Case 87
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Diagnosis: Plantar Fasciitis with tear Formerly believed to be a chronic inflammatory condition, plantar fasciitis is now considered a degenerative process involving the plantar fascial origin at the medial tubercle of the calcaneus. Risk factors for plantar fasciitis with or without tears include anatomic factors such as pes planus, pes cavus, excessive femoral anteversion, and increased body weight, as well as certain activities, particularly running. Patients present with long-standing heel pain with or without more acute symptoms if there is a superimposed fascial tear. In terms of imaging, both MRI and ultrasound can identify fasciitis as an area of thickening and increased signal (MRI) or diminished echogenicity (Ultrasound), usually involving the medial fibers at the calcaneal origin. A tear would manifest as an abnormal linear cleft usually at the calcaneal origin or immediately distal to the calcaneus. Treatment includes NSAIDS, orthotics, stretching exercises and percutaneous procedures such as injection of cortisone or platelet-rich plasma (PRP). If conservative treatment fails, surgical fasciotomy is also a treatment option.
Ultrasound of the Month – Case 87
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