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Is There a Role for MRI in Plantar Heel Pain
Muhammad Ali Fazal1, Demetris Tsekes1, Irshad Baloch1
1Barnet & Chase Farm Hospitals, Royal Free Hospitals NHS Foundation Trust, Enfield, London, UK.
Introduction:
There is an increasing trend to investigate plantar heel pain with magnetic resonance imaging (MRI) scan though plantar fasciitis is the most common cause. The purpose of our study was to evaluate the role of MRI in patients presenting with plantar heel pain.
Methods:
Case notes and MRI scans of 141 patients with a clinical diagnosis of plantar fasciitis were reviewed retrospectively. There were 98 females and 43 males patients. Fourteen patients had bilateral symptoms. Average age for male patients was 51 years (range = 26-78 years), and for female patients the average age was 52 years (range = 29-76 years).
Results:
A total of 121 feet had MRI features suggestive of plantar fasciitis. MRI was normal in 32 feet. There was one case of stress fracture of calcaneus and another of a heel fibroma diagnosed on MRI scan.
Conclusions:
In our study, MRI scan was normal in 20.7% of the cases; 1.3% had a diagnosis other than plantar fasciitis but no sinister pathology. We therefore conclude that MRI scan is not routinely indicated and key is careful clinical assessment.
Levels Of Evidence:
Therapeutic, Level IV: Retrospective, Case series.
Insights
Magnetic resonance imaging (MRI) is often used for plantar heel pain, but this study found it is not routinely indicated. Careful clinical assessment is key for diagnosing plantar fasciitis.
Area of Science:
- Radiology
- Orthopedics
- Musculoskeletal Imaging
Background:
- Plantar heel pain is commonly diagnosed as plantar fasciitis.
- Magnetic resonance imaging (MRI) is increasingly utilized for evaluating plantar heel pain.
- The diagnostic utility of MRI in these cases requires further investigation.
Purpose of the Study:
- To evaluate the role and diagnostic yield of MRI in patients presenting with plantar heel pain.
- To determine the effectiveness of MRI in identifying plantar fasciitis versus other causes of heel pain.
Main Methods:
- Retrospective review of case notes and MRI scans from 141 patients with a clinical diagnosis of plantar fasciitis.
- Analysis included patient demographics (age, sex) and laterality of symptoms.
- Study design: Therapeutic, Level IV - Retrospective Case Series.
Main Results:
- MRI showed features suggestive of plantar fasciitis in 121 feet.
- MRI scans were normal in 32 feet (20.7%).
- Other diagnoses identified by MRI included calcaneal stress fracture (1 case) and heel fibroma (1 case).
Conclusions:
- MRI scans were normal in a significant percentage of patients (20.7%).
- Only a small percentage (1.3%) received a diagnosis other than plantar fasciitis, with no sinister pathologies identified.
- Routine MRI is not indicated for plantar heel pain; clinical assessment remains paramount.
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