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Ultrasound Diagnosis and Evaluation of Plantar Heel Pain

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  • 1 Department of Surgery, New York College of Podiatric Medicine, New York, NY.
  • | 2 Non-Surgical Foot and Ankle Service, Joe DiMaggio Sports Medicine Foot and Ankle Center, Hospital for Special Surgery, New York, NY.
  • | 3 New York University Langone Medical Center, New York, NY.
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Background

One of the most common causes of heel pain is plantar fasciitis; however, there are other pathologic disorders that can mimic the symptoms and clinical presentation of this disorder. The purpose of this study was to retrospectively review the prevalence of various pathologic disorders on ultrasound in patients with proximal plantar heel pain.

Methods

The medical records and diagnostic ultrasound reports of patients presenting with plantar heel pain between March 1, 2006, and March 31, 2007, were reviewed retrospectively, and the prevalence of various etiologies was collected. The inclusion criteria were based on their clinical presentation of plantar fasciitis or previous diagnosis of plantar fasciitis from an unknown source. Ultrasound evaluation was then performed to confirm the clinical diagnosis.

Results

We examined 175 feet of 143 patients (62 males and 81 females; age range, 16–79 years). Plantar fibromas were present in 90 feet (51%). Plantar fasciitis was diagnosed in 128 feet (73%). Coexistent plantar fibroma and plantar fascial thickening was found in 63 feet (36%). Of the 47 feet that were negative for plantar fasciitis on ultrasound, 27 (57%) revealed the presence of plantar fibroma.

Conclusions

Diagnostic ultrasound can effectively and safely identify the prevalence of various etiologies of heel pain. The high prevalence of plantar fibromas and plantar fascial tears cannot be determined by clinical examination alone, and, therefore, ultrasound evaluation should be performed for confirmation of diagnosis.

Corresponding author: Nicholas G. Argerakis, DPM, Department of Surgery, New York College of Podiatric Medicine, 53 E 124th St, New York, NY 10035. (E-mail: nargerakis@gmail.com)