Plantar Fascitis

About dynamic ultrasound study of chronic plantar fascitis.

In a previous post I wrote about the examination of the plantar aponeurosis;

repetitive traumas produce microtears of some fibers of the plantar aponeurosis, not only close to the site of its attachment but also distally, due to the own foot biomechanics of the patients.

Today I show you the case of a chronic partial rupture of plantar aponeurosis in 20-year-old male soccer player.

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Ge Stir (left) and Coronal T2w (right) Mri sequences (0.3 Tesla).

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Axial T2w (left) and Coronal Fast Stir (right) Mri scans of the same patient (0.3 Tesla).

As usually I also perform the dynamic ultrasound exam, togheter with elastosonosgraphy evaluation.

The elastosonography examination better depicts the presence of a granulation tissue (green colour) as happened after a partial tear inside the fibrous scar of a chronic plantar fascitis.

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Peroneal Tendon Rupture

About integrated imaging of complete peroneus brevis tendon rupture.

Peroneal tendons are frequently causes of lateral ankle pain and instability.

This is the case of a patient with an history of chronic ankle instability; gross irregularity of the retromalleolar groove and peroneal tubercle are evident.

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Axial T2w (left) and Sagittal 3D Sharc Mri scans (0.3 tesla); red arrows indicate the gross irregularity of retromalleolar groove surface.

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Sagittal multisequences and Axial mri scans of the same patient; red arrows indicate the complete rupture of the peroneus brevis tendon. (0.3 Tesla Mri).

The best way to understand the entire pathologic picture is to combine Mri and dynamic ultrasound imaging; on the video below you can appreciate the gross irregularity of the cortical surface that is the site of chronic tendon impingement. Repetitive microtraumas lead to complete tendon rupture.