Disorders of the plantar aponeurosis: a spectrum of MR imaging findings.

Abstract

97 he plantar aponeurosis, or plantar fascia, has received considerable attention in the scientific literature and has been shown to be the most important structure for dynamic longitudinal arch support in the foot [1]. The plantar aponeurosis comprises histologically both collagen and elastic fibers arranged in a particular network of bundles and is a tough tendinous (rather than a fascial) layer of the plantar aspect of the foot. This sophisticated combination of fibers, having different biomechanical properties during stress application to the plantar aponeurosis, affords an increased modulus of elasticity during weight bearing [2]. Abnormalities affecting the plantar aponeurosis are well recognized. Patients with suspected abnormality involving the aponeurosis traditionally have been examined with conventional radiography and bone scintigraphy and occasionally with sonography. Although conventional radiography remains essential in the initial diagnostic approach, MR imaging is particularly well suited for depicting the plantar aponeurosis (Fig. 1) and for detecting the presence of a wide range of disorders. MR imaging also may be useful in limiting the broad differential diagnosis of subcalcaneal heel pain. This pictorial review summarizes the most common abnormalities that affect the plantar aponeurosis and addresses their characteristic MR imaging features. Although in clinical practice plantar fasciitis is the most common diagnosis in patients with heel pain, a spectrum of disorders may also affect the Disorders of the Plantar Aponeurosis: A Spectrum of MR Imaging Findings Daphne J. Theodorou 1 , Stavroula J. Theodorou, Shella Farooki, Y. Kakitsubata, Donald Resnick