Semin Musculoskelet Radiol 2022; 26(06): 684-694
DOI: 10.1055/s-0042-1760211
Review Article

Presurgical Perspective and Postsurgical Evaluation of the Plantar Fascia

Luis S. Beltran
1   Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts
› Author Affiliations

Abstract

The plantar fascia is an important structure in the foot that acts as a major stabilizer of the longitudinal arch, along with the midfoot ligaments and intrinsic and extrinsic muscles. It is composed predominantly of longitudinally oriented collagen fibers that vary in thickness and are organized into bundles closely associated with the interstitial tissues of the foot. This composition enables the plantar fascia to withstand the weight-bearing forces concentrated on the foot while standing, jumping, walking, or running. This article discusses the normal anatomy and the various pathologies that affect the plantar fascia with an emphasis on presurgical and postoperative appearances on magnetic resonance and ultrasonography imaging.



Publication History

Article published online:
15 February 2023

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  • References

  • 1 Draghi F, Gitto S, Bortolotto C, Draghi AG, Ori Belometti G. Imaging of plantar fascia disorders: findings on plain radiography, ultrasound and magnetic resonance imaging. Insights Imaging 2017; 8 (01) 69-78
  • 2 Stecco C, Corradin M, Macchi V. et al. Plantar fascia anatomy and its relationship with Achilles tendon and paratenon. J Anat 2013; 223 (06) 665-676
  • 3 Hedrick MR. The plantar aponeurosis. Foot Ankle Int 1996; 17 (10) 646-649
  • 4 Yu JS. Pathologic and post-operative conditions of the plantar fascia: review of MR imaging appearances. Skeletal Radiol 2000; 29 (09) 491-501
  • 5 Berkowitz JF, Kier R, Rudicel S. Plantar fasciitis: MR imaging. Radiology 1991; 179 (03) 665-667
  • 6 Gitto S, Draghi F. Normal sonographic anatomy of the wrist with emphasis on assessment of tendons, nerves, and ligaments. J Ultrasound Med 2016; 35 (05) 1081-1094
  • 7 Precerutti M, Bonardi M, Ferrozzi G, Draghi F. Sonographic anatomy of the ankle. J Ultrasound 2013; 17 (02) 79-87
  • 8 Riddle DL, Schappert SM. Volume of ambulatory care visits and patterns of care for patients diagnosed with plantar fasciitis: a national study of medical doctors. Foot Ankle Int 2004; 25 (05) 303-310
  • 9 DeMaio M, Paine R, Mangine RE, Drez Jr D. Plantar fasciitis. Orthopedics 1993; 16 (10) 1153-1163
  • 10 Ieong E, Afolayan J, Carne A, Solan M. Ultrasound scanning for recalcitrant plantar fasciopathy. Basis of a new classification. Skeletal Radiol 2013; 42 (03) 393-398
  • 11 Kwong PK, Kay D, Voner RT, White MW. Plantar fasciitis. Mechanics and pathomechanics of treatment. Clin Sports Med 1988; 7 (01) 119-126
  • 12 Snider MP, Clancy WG, McBeath AA. Plantar fascia release for chronic plantar fasciitis in runners. Am J Sports Med 1983; 11 (04) 215-219
  • 13 Hill Jr JJ, Cutting PJ. Heel pain and body weight. Foot Ankle 1989; 9 (05) 254-256
  • 14 Powell M, Post WR, Keener J, Wearden S. Effective treatment of chronic plantar fasciitis with dorsiflexion night splints: a crossover prospective randomized outcome study. Foot Ankle Int 1998; 19 (01) 10-18
  • 15 McCarthy DJ, Gorecki GE. The anatomical basis of inferior calcaneal lesions. A cryomicrotomy study. J Am Podiatry Assoc 1979; 69 (09) 527-536
  • 16 Gibbon WW, Long G. Ultrasound of the plantar aponeurosis (fascia). Skeletal Radiol 1999; 28 (01) 21-26
  • 17 Abul K, Ozer D, Sakizlioglu SS, Buyuk AF, Kaygusuz MA. Detection of normal plantar fascia thickness in adults via the ultrasonographic method. J Am Podiatr Med Assoc 2015; 105 (01) 8-13
  • 18 Akfirat M, Sen C, Günes T. Ultrasonographic appearance of the plantar fasciitis. Clin Imaging 2003; 27 (05) 353-357
  • 19 Ríos-Díaz J, Martínez-Payá JJ, del Baño-Aledo ME, de Groot-Ferrando A, Botía-Castillo P, Fernández-Rodríguez D. Sonoelastography of plantar fascia: reproducibility and pattern description in healthy subjects and symptomatic subjects. Ultrasound Med Biol 2015; 41 (10) 2605-2613
  • 20 Sconfienza LM, Silvestri E, Orlandi D. et al. Real-time sonoelastography of the plantar fascia: comparison between patients with plantar fasciitis and healthy control subjects. Radiology 2013; 267 (01) 195-200
  • 21 Daly PJ, Kitaoka HB, Chao EY. Plantar fasciotomy for intractable plantar fasciitis: clinical results and biomechanical evaluation. Foot Ankle 1992; 13 (04) 188-195
  • 22 Gormley J, Kuwada GT. Retrospective analysis of calcaneal spur removal and complete fascial release for the treatment of chronic heel pain. J Foot Surg 1992; 31 (02) 166-169
  • 23 Leach RE, Seavey MS, Salter DK. Results of surgery in athletes with plantar fasciitis. Foot Ankle 1986; 7 (03) 156-161
  • 24 Lester DK, Buchanan JR. Surgical treatment of plantar fasciitis. Clin Orthop Relat Res 1984; (186) 202-204
  • 25 Schepsis AA, Leach RE, Gorzyca J. Plantar fasciitis. Etiology, treatment, surgical results, and review of the literature. Clin Orthop Relat Res 1991; (266) 185-196
  • 26 Baxter DE, Thigpen CM. Heel pain—operative results. Foot Ankle 1984; 5 (01) 16-25
  • 27 Hofmeister EP, Elliott MJ, Juliano PJ. Endoscopic plantar fascia release: an anatomical study. Foot Ankle Int 1995; 16 (11) 719-723
  • 28 Lewis G, Gatti A, Barry LD, Greenberg PM, Levenson M. The plantar approach to heel surgery: a retrospective study. J Foot Surg 1991; 30 (06) 542-546
  • 29 Reeve F, Laughlin RT, Wright DG. Endoscopic plantar fascia release: a cross-sectional anatomic study. Foot Ankle Int 1997; 18 (07) 398-401
  • 30 Murphy GA, Pneumaticos SG, Kamaric E, Noble PC, Trevino SG, Baxter DE. Biomechanical consequences of sequential plantar fascia release. Foot Ankle Int 1998; 19 (03) 149-152
  • 31 Thordarson DB, Kumar PJ, Hedman TP, Ebramzadeh E. Effect of partial versus complete plantar fasciotomy on the windlass mechanism. Foot Ankle Int 1997; 18 (01) 16-20
  • 32 Yu JS, Smith G, Ashman C, Kaeding C. The plantar fasciotomy: MR imaging findings in asymptomatic volunteers. Skeletal Radiol 1999; 28 (08) 447-452
  • 33 Yu JS, Spigos D, Tomczak R. Foot pain after a plantar fasciotomy: an MR analysis to determine potential causes. J Comput Assist Tomogr 1999; 23 (05) 707-712
  • 34 Kim W, Voloshin AS. Role of plantar fascia in the load bearing capacity of the human foot. J Biomech 1995; 28 (09) 1025-1033
  • 35 Karasick D, Schweitzer ME. Tear of the posterior tibial tendon causing asymmetric flatfoot: radiologic findings. AJR Am J Roentgenol 1993; 161 (06) 1237-1240
  • 36 Kitaoka HB, Luo ZP, An KN. Mechanical behavior of the foot and ankle after plantar fascia release in the unstable foot. Foot Ankle Int 1997; 18 (01) 8-15
  • 37 Kitaoka HB, Luo ZP, An KN. Effect of the posterior tibial tendon on the arch of the foot during simulated weightbearing: biomechanical analysis. Foot Ankle Int 1997; 18 (01) 43-46
  • 38 Sellman JR. Plantar fascia rupture associated with corticosteroid injection. Foot Ankle Int 1994; 15 (07) 376-381
  • 39 Suzue N, Iwame T, Kato K. et al. Plantar fascia rupture in a professional soccer player. J Med Invest 2014; 61 (3-4): 413-416
  • 40 Saxena A, Fullem B. Plantar fascia ruptures in athletes. Am J Sports Med 2004; 32 (03) 662-665
  • 41 Pascoe SC, Mazzola TJ. Acute medial plantar fascia tear. J Orthop Sports Phys Ther 2016; 46 (06) 495
  • 42 Louwers MJ, Sabb B, Pangilinan PH. Ultrasound evaluation of a spontaneous plantar fascia rupture. Am J Phys Med Rehabil 2010; 89 (11) 941-944
  • 43 Leach R, Jones R, Silva T. Rupture of the plantar fascia in athletes. J Bone Joint Surg Am 1978; 60 (04) 537-539
  • 44 Rolf C, Guntner P, Ericsäter J, Turan I. Plantar fascia rupture: diagnosis and treatment. J Foot Ankle Surg 1997; 36 (02) 112-114
  • 45 Pai VS. Rupture of the plantar fascia. J Foot Ankle Surg 1996; 35 (01) 39-40
  • 46 Ahstrom Jr JP. Spontaneous rupture of the plantar fascia. Am J Sports Med 1988; 16 (03) 306-307
  • 47 Herrick RT, Herrick S. Rupture of the plantar fascia in a middle-aged tennis player. A case reports. Am J Sports Med 1983; 11 (02) 95
  • 48 McElgun TM, Cavaliere RG. Sequential bilateral rupture of the plantar fascia in a tennis player. J Am Podiatr Med Assoc 1994; 84 (03) 137-141
  • 49 Jeswani T, Morlese J, McNally EG. Getting to the heel of the problem: plantar fascia lesions. Clin Radiol 2009; 64 (09) 931-939
  • 50 Schaarup SO, Burgaard P, Johannsen FE. Surgical repair of complete plantar fascia ruptures in high-demand power athletes: an alternative treatment option. J Foot Ankle Surg 2020; 59 (01) 195-200
  • 51 Christel P, Rigal S, Poux D, Roger B, Witvoët J. Surgical treatment of rupture of the plantar fascia. [in French]. Rev Chir Orthop Repar Appar Mot 1993; 79 (03) 218-225
  • 52 Fuiano M, Mosca M, Caravelli S. et al. Current concepts about treatment options of plantar fibromatosis: a systematic review of the literature. Foot Ankle Surg 2019; 25 (05) 559-564
  • 53 Meyers AL, Marquart MJ. Plantar Fibromatosis. Treasure Island, FL: StatPearls Publishing; 2022
  • 54 Sammarco GJ, Mangone PG. Classification and treatment of plantar fibromatosis. Foot Ankle Int 2000; 21 (07) 563-569
  • 55 Espert M, Anderson MR, Baumhauer JF. Current concepts review: Plantar fibromatosis. Foot Ankle Int 2018; 39 (06) 751-757
  • 56 Morrison WB, Schweitzer ME, Wapner KL, Lackman RD. Plantar fibromatosis: a benign aggressive neoplasm with a characteristic appearance on MR images. Radiology 1994; 193 (03) 841-845
  • 57 Souza BG, de Souza Júnior GZ, Rodrigues RM, Dias DS, de Oliveira VM. Surgical treatment of a case of Ledderhose's disease: a safe plantar approach to subtotal fasciectomy. Case Rep Orthop 2015; 2015: 509732
  • 58 Quinn SF, Erickson SJ, Dee PM. et al. MR imaging in fibromatosis: results in 26 patients with pathologic correlation. AJR Am J Roentgenol 1991; 156 (03) 539-542
  • 59 Griffith JF, Wong TY, Wong SM, Wong MW, Metreweli C. Sonography of plantar fibromatosis. AJR Am J Roentgenol 2002; 179 (05) 1167-1172
  • 60 Pineda C, Espinosa R, Pena A. Radiographic imaging in osteomyelitis: the role of plain radiography, computed tomography, ultrasonography, magnetic resonance imaging, and scintigraphy. Semin Plast Surg 2009; 23 (02) 80-89
  • 61 Rawool NM, Nazarian LN. Ultrasound of the ankle and foot. Semin Ultrasound CT MR 2000; 21 (03) 275-284
  • 62 Abate M, Schiavone C, Di Carlo L, Salini V. Achilles tendon and plantar fascia in recently diagnosed type II diabetes: role of body mass index. Clin Rheumatol 2012; 31 (07) 1109-1113
  • 63 Craig ME, Duffin AC, Gallego PH. et al. Plantar fascia thickness, a measure of tissue glycation, predicts the development of complications in adolescents with type 1 diabetes. Diabetes Care 2008; 31 (06) 1201-1206
  • 64 Benitez-Aguirre PZ, Craig ME, Jenkins AJ. et al. Plantar fascia thickness is longitudinally associated with retinopathy and renal dysfunction: a prospective study from adolescence to adulthood. J Diabetes Sci Technol 2012; 6 (02) 348-355
  • 65 Hata Y, Shigematsu H, Tsushima M. et al. Serum lipid and lipoprotein profiles in patients with xanthomas: a correlative study on xanthoma and atherosclerosis (I). Jpn Circ J 1981; 45 (11) 1236-1242
  • 66 Zahradnik TM, Cresswell M, Squier K. et al. Can Achilles tendon xanthoma be distinguished from Achilles tendinopathy using Dixon method MRI? A cross-sectional exploratory study. BMC Musculoskelet Disord 2021; 22 (01) 627
  • 67 Bude RO, Adler RS, Bassett DR. Diagnosis of Achilles tendon xanthoma in patients with heterozygous familial hypercholesterolemia: MR vs sonography. AJR Am J Roentgenol 1994; 162 (04) 913-917
  • 68 Fernandes EÁ, Santos EH, Tucunduva TC, Ferrari AJ, Fernandes AR. Achilles tendon xanthoma imaging on ultrasound and magnetic resonance imaging. [in Portuguese]. Rev Bras Reumatol 2015; 55 (03) 313-316