Presentation
Heel pain for more than four months. History of trauma 5 years ago with fracture of the talus.
Patient Data
Thickening and an intrasubstance high signal intensity changes on fluid-sensitive sequences of the posterior aspect of the plantar fascia near its calcaneal attachment with associated surrounding oedema of the plantar muscles mainly the quadratus plantae muscle and fat pad. Marrow oedema of the calcaneus mainly the medial calcaneal tuberosity.
A non-displaced fracture of the medial tubercle of the posterior process of the talus with cystic changes and a small osteophyte in keeping with an old Cedell fracture.
Small calcaneal defect and irregularity at the plantar fascia attachment with associated thickening of the plantar fascia near its calcaneal attachment.
Case Discussion
Plantar fasciitis is a degenerative irritation of the plantar fascia at the insertion on the medial process of the calcaneal tuberosity. It is the most common cause of plantar pain with different terms describing the condition including tennis heel, policeman's or jogger's heel. Radiographic findings include plantar fascia thickening, cortical irregularity with marrow oedema, muscle and fat pad oedema surrounding the fascia, as in this case. Cedell fracture was from prior trauma.
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