Plantar Fascia

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The plantar fascia is a fibrous aponeurosis attaching to the plantar anterior aspect of the calcaneus, coursing adjacent to the plantar margin of the flexor dig-itorum brevis muscle, and sending digital slips to each toe. Interconnecting transverse fasciculi are present between the digital slips. The superficial transverse metatarsal ligaments and the flexor digitorum brevis tendons also have attachments to the plantar fascia. A smaller lateral band of the plantar fascia is present, extending between the calcaneus and the base of the fifth metatarsal. Acute tear of the plantar fascia is occasionally seen in athletes (Fig. 51) [116]. In this population, surgical repair is typically performed. Chronic degeneration of the plantar fascia has been termed plantar fasciitis, despite a lack of inflammation [117]. This is manifested as thickening, heterogeneous appearance, and increased signal intensity at MRI (Fig. 52) [118]. Symptomatic relief has been reported from surgical release of the degenerated plantar fascia [119], which may be performed endoscopically, with improved recovery times compared with open release [120]. A biomechanical study has shown that increased stress is placed on the ligaments of the hindfoot after plantar fascia release [121]

MRI provides accurate evaluation of the articular cartilage, bones, ligaments, tendons, nerves, and vessels of the ankle. A thorough understanding of the anatomy and imaging manifestations of ankle injury is necessary for adequate evaluation. MRI is useful in treatment planning by evaluating the extent of injury and the presence of associated injuries.

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