Radiologic evaluation of chronic foot pain

Chronic foot pain is a common and often disabling clinical complaint that can interfere with a patient's routine activities. Despite careful and detailed clinical history and physical examination, providing an accurate diagnosis is often difficult because chronic foot pain has a broad spectrum of potential causes. Therefore, imaging studies play a key role in diagnosis and management. Initial assessment is typically done by plain radiography; however, magnetic resonance imaging has superior soft-tissue contrast resolution and multiplanar capability, which makes it important in the early diagnosis of ambiguous or clinically equivocal cases when initial radiographic findings are inconclusive. Computed tomography displays bony detail in stress fractures, as well as in arthritides and tarsal coalition. Bone scanning and ultrasonography also are useful tools for diagnosing specific conditions that produce chronic foot pain.