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Thursday, January 11, 2018

Plantar Fascial Tearing with Intense Inflammation MRI Images

The Plantar Fascia on the bottom of the foot should be as dark as the Achilles Tendon shown here.

The Plantar Fascia should be uniform thickness and density. Here it is seen rising up and with gray holes. 

The slice through the bottom of the foot under the heel bone showing a bursae sac of intense inflammation. 

This is the section that is at a right angle to the raised part of the plantar fascia seen above. The fascia above my arrow should be a solid dark fiber like the Achilles. In this image, it is showing 90% torn with the gray signifying fluid and scar tissue. 

The image just in front of the last view looking more solid, although some irregularity and less density.

This is the initial image again in our series showing a section of plantar fascia separated from the bone. 

A defect in the plantar fascia more to the outside of the foot. The arrow denotes the defect and is surrounded by intense inflammation probably a bursal sac. 

Only slight irregularity noted in the plantar at this section, but see the inflammation is so intense it distorts the normal fat pad below the arrow. 



This is really the best image of the problem. The patient's image shows the split partial horizontal tear of the plantar fascia seen as is there was a layer of Oreo cookie in the fascia. How do we know it is injured, the intense inflammation under the tear where the swelling is pulled downward by gravity. I would not want to walk on that heal. 


This is the same image of the plantar fascia 1/8th inch further under the heel bone. It looks totally fine, so the tear is the 1/2 inch in front of its attachement into the heel. The swelling from infracalcaneal bursitis will travel all under the heel and the reason patients can not walk well. The plantar fascial tear protocol should be started. Plantar bursitis will take some work off-weighting the heel to transfer the weight into the arch. 

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.