Causes and localization features
The primary trigger for the development of the pathology is persistent biomechanical stress leading to chronic tissue microtrauma. Most frequently, the pathological process involves the central bundle of the plantar fascia, specifically the zone of its direct attachment to the calcaneus. It is precisely here that patients experience pronounced discomfort and pain.
Ultrasound and diagnostic imaging
To confirm the diagnosis, modern visualization methods are used:
- Ultrasound diagnostics: reveals characteristic thickening of the fascia exceeding the normal limits of 5 mm, and also records the loss of the normal echogenic fibrillar structure.
- MRI diagnostics: demonstrates increased tissue thickness and elevated signal intensity on fluid-sensitive sequences such as STIR. This indicates active inflammation, including edema in the fascia attachment zone and bone marrow edema in the adjacent calcaneal spur.
Significance of radiography and differential diagnosis
Many patients and physicians focus on the calcaneal spur (calcaneal spur), but this bony outgrowth can also be present in healthy individuals without signs of fasciitis. Plain radiography is not critical for making an accurate diagnosis.
When fascia thickening is detected, differential diagnosis must be performed with the following conditions:
- Seronegative arthropathies.
- Plantar fibroma.
- Hyperlipidemia.
Class and exam questions
What is the main cause of plantar fasciitis?
The main cause is chronic microtrauma to the plantar fascia caused by persistent biomechanical stress.
What changes does ultrasound show in this disease?
Ultrasound examination demonstrates thickening of the fascia (with a normal thickness of up to 5 mm) and loss of its normal echogenic fibrillar structure.
Does standard radiography help in diagnosis?
No, plain radiography plays no role in establishing the diagnosis, as a calcaneal spur can also occur in individuals without plantar fasciitis.
What else to study on this topic
- Tarsal coalitions and the «C» sign on radiographs
- Posterior ankle impingement syndrome and changes in the os trigonum
- Tarsal sinus syndrome and the anatomy of the tarsal canal
- Anatomical features and functions of the plantar plate
- Compression neuropathies of the tibial nerve
Master the entire topic in the "Traumatology" course
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- Complete study guide on «Plantar fasciitis» and 812 more pages of the subject
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