Plantar Fasciitis: MRI Findings

Plantar fasciitis is the most common cause of heel pain in the athlete and represents a low-grade inflammation involving the plantar aponeurosis and surrounding structures.

MRI findings of acute plantar fasciitis include increased intrasubstance signal intensity on T2-weighted and STIR images, with or without associated fascial thickening. The normal plantar fascial thickness is less than about 4 mm. The average thickness of the plantar fascia in patients with plantar fasciitis is about 7.5 mm.

Signal abnormality may predominantly involve the perifascial soft-tissues (deep and/or superficial) and adjacent calcaneus. Enhancement of the inflamed perifascial soft tissues may be also seen.

Calcaneal enthesophytes rarely cause plantar fasciitis and can be seen in patients with plantar fasciitis and asymptomatic controls.

The image above reveals a normal-thickness plantar fascia associated with abnormal peri fascial and calcaneal signal intensity.

References

• Berkowitz JF, Kier R, Rudicel S. Plantar fasciitis: MR imaging. Radiology. 1991 Jun;179(3):665-7.
• Theodorou DJ, Theodorou SJ, Farooki S, Kakitsubata Y, Resnick D. Disorders of the plantar aponeurosis: a spectrum of MR imaging findings. AJR Am J Roentgenol. 2001 Jan;176(1):97-104.