Exploring plantar aponeurosis disorders: beyond the classics

Area of Science:

• Orthopedics
• Radiology
• Pathology

Background:

• Plantar aponeurosis (PA) disorders are a frequent cause of heel pain and functional limitation.
• Plantar fasciitis is the most common PA pathology, often linked to mechanical overload.
• PA can also be affected by inflammatory, metabolic, and neoplastic conditions.

Purpose of the Study:

• To provide a comprehensive review of the full spectrum of plantar aponeurosis disorders.
• To emphasize the radiologic features and diagnostic pitfalls of various PA conditions.
• To highlight the role of imaging in diagnosis, evaluation, and postoperative assessment.

Main Methods:

• Comprehensive literature review.
• Discussion of anatomical, histological, and biomechanical aspects of the PA.
• Emphasis on radiologic features from ultrasound and MRI.

Main Results:

• Plantar aponeurosis disorders encompass mechanical overload, inflammatory enthesitis, fibromatosis, xanthomas, and tumoral calcinosis.
• Ultrasound is effective for initial assessment; MRI offers superior soft-tissue detail.
• Recognizing typical imaging patterns is crucial for diagnosis and postoperative interpretation.

Conclusions:

• Accurate diagnosis and differentiation of PA disorders require understanding anatomy, histology, and biomechanics.
• Imaging, particularly ultrasound and MRI, plays a vital role in evaluating PA conditions.
• Proper interpretation of imaging findings is essential for guiding treatment and managing postoperative changes.