Radiographics aspects of plantar fasciitis

Abstract

A high medial arch and valgus of the hindfoot are risk factors for plantar fasciitis (PF). It is possible to identify heel spurs, as well as evaluate the relation between foot bones by weight-bearing radiographs. Objectives: 1. Investigate the relation between heel spurs and diagnosis of PF. 2. Measure of the medial longitudinal arch and valgus position of the hindfoot in PF. Methods: Radiographic evaluation was performed through anteroposterior (AP) and lateral views (weight-bearing) in 48 feet (24 patients). Thirty-four feet had clinical evidence of FP. The appearance of heel spurs was investigated in all feet. Talocalcaneal (on AP radiographs) angle, talar-first metatarsal (Meary) angle, Moreau Costa-Bertani (MCB) angle and calcaneal pitch (CPA) angle were measured in all painful feet. Results: Plantar spurs were present in 24 (70,6%) feet with FP and in 10 (71,4%) asymptomatic feet (p=0,62). Cavus feet were observed in 50%, 44,1% and 35,3% of cases, using the Meary, MCB and CPA angles, respectively. Flat feet were identified in 35,3%, 20,6% and 11,7% of feet with PF, also by using the MCB, CPA and Meary angles, respectively. The talocalcaneal angle was found to be decreased in 17,6% and increased in 11,8% of painful feet. Conclusion: The presence of a plantar heel spur cannot be used solely for diagnosis of PF as it is not necessarily related to pain in the hindfoot. Patients with cavus and flat feet showed a high incidence of PF.