Painful heel: MR imaging findings

Heel pain is a common and frequently disabling clinical complaint that may be caused by a broad spectrum of osseous or soft-tissue disorders. These di sorders are classified on the basis of anatomic origin and predominant loca tion of heel pain to foster a better understanding of this complaint. The d isorders include plantar fascial lesions (fasciitis, rupture, fibromatosis, xanthoma), tendinous lesions (tendinitis, tenosynovitis), osseous lesions (fractures, bone bruises, osteomyelitis, tumors), bursal lesions (retrocalc aneal bursitis, retroachilleal bursitis), tarsal tunnel syndrome, and heel plantar fat pad abnormalities. With its superior soft-tissue contrast resol ution and multiplanar capability, magnetic resonance (MR) imaging can help determine the cause of heel pain and help assess the extent and severity of the disease in ambiguous or clinically equivocal cases. Careful analysis o f MR imaging findings and correlation of these findings with patient histor y and findings at physical examination can suggest a specific diagnosis in most cases. The majority of patients with heel pain can be successfully tre ated conservatively, but in cases requiring surgery (eg, plantar fascia rup ture in competitive athletes, deeply infiltrating plantar fibromatosis, mas ses causing tarsal tunnel syndrome), MR imaging is especially useful in pla nning surgical treatment by showing the exact location and extent of the le sion.