Magnetic Resonance Imaging for Plantar Fasciitis - A Detailed Analysis

What Is Plantar Fasciitis?

Plantar fasciitis is a peculiar inflammatory condition that explicitly affects the foot. A thick tissue strap that stretches the foot horizontally, bridging the toe and the heel region of the foot, is called plantar fascia. It runs through the undersurface of the foot. In plantar fasciitis, the plantar fascia gets inflamed and irritated. As a result, the affected person may experience stabbing foot pain. In addition to pain, the affected foot may elicit puffiness in the heel region, and the foot tends to be stiff and rigid. It can impact one's ability to walk and perform routine activities. It compromises the quality of life and restricts foot movements.

Strain and overuse are considered to be two critical factors that can trigger plantar fasciitis. Long-term standing can bring micro-tears in the fascia, eventually leading to inflammatory changes in the foot. In addition, structural foot deformities and foot injuries can also contribute to plantar fasciitis. Various factors always influence the etiology; hence, it is considered multifactorial. The discomfort is more while placing the foot on the ground after a break, mostly in the morning while getting off the bed.

How Is Plantar Fasciitis Diagnosed?

Various clinical and therapeutic assessments are made to diagnose plantar fasciitis. Patient history and symptoms may provide hints at a diagnosis. Heel pain, particularly in the morning immediately after getting off the bed, is a classic sign of plantar fasciitis. However, a confirmatory diagnosis is often obtained with the help of diagnostic interventions like radiographs, ultrasounds, and other imaging modalities. X-rays are the routinely preferred diagnostic intervention that reflects changes suggestive of calcifications in the fascia. Ultrasound scans employ ultrasonic sound waves to visualize soft tissue changes. The changes in the plantar fascia can be seen in the ultrasound images, effectively contributing to disease diagnosis.

What Is the Role of Magnetic Resonance Imaging in Plantar Fasciitis?

Magnetic resonance imaging (MRI), though not the primary diagnostic intervention, can effectively throw light on the etiological factors. It employs magnetic waves to bring out a three-dimensional picturization of the organs or body parts. It enables a detailed and comprehensive evaluation of the microstructure of the plantar fascia. Magnetic resonance imaging sketches both the soft and hard tissue parts, making bony and fascia changes more evident and defined. MRI also aids in ruling out other possibilities for heel pain and facilitating the diagnosis of plantar fasciitis. However, MRI is advised only for indicated cases of heel pain, where other therapeutic interventions fail to bring out the desired outcome and pain reduction.

What Are the MRI Findings That Are Suggestive of Plantar Fasciitis?

Certain MRI findings unequivocally confirm the plantar fasciitis diagnosis. Some of the routine MRI findings that are suggestive of plantar fasciitis include the following:

• Enhanced plantar fascia thickness is more pronounced at the heel rather than the toe region.

• Intrafascial swelling is another prominent MRI finding of plantar fasciitis, in which MRI reveals the presence of fluid-like gathering within the plantar fascia. In addition, the adjoining fat pad also appears to be swollen, which is more evident in MRI than in other diagnostic techniques.

• Magnetic resonance imaging techniques can accurately determine the point of rupture or breach in the plantar fascia.

• All three tissue bundles that constitute the plantar fascia can be pictured through MRI. Any structural alterations in the plantar fascia bundles and their adjoining muscles can be appreciated through magnetic resonance imaging techniques.

What Are the Advantages of Magnetic Resonance Imaging for Plantar Fasciitis Over Other Imaging Techniques?

Magnetic resonance imaging techniques hold an upper hand over other imaging techniques concerning plantar fasciitis.

• MRI can effectively detect even less distinguishable changes in the plantar fascia, which enables the detection of the plantar fasciitis at its initial stage. Early and timely diagnosis is critical for the treatment outcome. The earlier the condition is detected and therapeutic intervention is sought, the higher the prognosis.

• MRI offers a wider view of the foot than other imaging techniques, covering adjacent supportive structures like ligaments and muscles. The comprehensive view aids in exposing other foot issues apart from the problem within the plantar fascia.

• In addition to a wider view, MRI depicts detailed imaging of the foot structures. The more detailed view maps out the extent and intensity of inflammatory changes associated with the plantar fascia.

• MRI, being less invasive with no risk of radiation like X-ray, makes it a better diagnostic tool for plantar fasciitis in pregnant women. It also eliminates unwanted radiation exposure imposed by repeated imaging of the foot.

• Besides the diagnostic purpose, detailed imaging with MRI facilitates the process of treatment planning and contributes to the prognosis by guiding the medical professional to the right diagnosis.

What Are the Potential Disadvantages Associated With Magnetic Resonance Imaging for Plantar Fasciitis?

Besides various advantages, certain disadvantages limit the application of magnetic resonance imaging for plantar fasciitis. Some of the limiting factors include the following:

• The high cost associated with magnetic resonance imaging techniques makes it less affordable for all economic classes.

• Sophisticated equipment is needed for the imaging technique, which requires trained technicians to obtain accurate imaging results.

• MRI is not advisable for individuals who have had embedded metals in their body, like pacemakers (electrical devices for rhythmic heart beating). The magnetic waves employed for MRI may interact with the metal bodies and hence are not advised in such patients.

• MRI generally takes longer than regular radiographic imaging, during which the patient must be motionless.

• Precisely interpreting and analyzing images is another challenging part, as it warrants the need for experienced medical professionals.

• Certain patients with claustrophobia (scared to be in closed space) elicit discomfort and trouble during magnetic resonance imaging.

Conclusion:

Magnetic Resonance Imaging is an effective imaging tool for plantar fasciitis. The detailed and comprehensive picturization of the fascia and its adjoining structures is possible with Magnetic Resonance Imaging techniques. The MRI findings guide the medical professional in exposing the causative factor that triggered plantar fasciitis. It can provide detailed picturization in a multiplanar model so that irregularities or changes in any plantar fascia layer can be precisely revealed. However, the magnetic resonance imaging technique is employed only for indicated cases as per the advice from the concerned doctors.