Wearing High Heel and Planter Fasciitis: MRI Evaluation

Purpose: To determine the type and frequency of characteristic MRI changes of the plantaris fascia in patients with painful heel and wear high heel shoes. Materials and Methods: 40 patients with painful heel, wearing high heels, their age raged from 25-50 years, underwent MR imaging. A control group included 20 subjects with no history of painful heel & not using high heels were included. Associations between the presence of palnter fasciitis, high heel, and body mass index, height of the heel, MRI imaging, self-reported co-morbidities and current heel pain were then explored. MR images were obtained with a 1.5-T superconducting MR imager with a 5-inch (13-cm) standard small flexible surface coil. Results: Thirty cases (75%) of the clinically suspected of plantar fasciitis was established by MR imaging. The most common finding was a peritendinous edema at the calcaneal insertion site which was found in all 30 patients. In 16 patients (53%), an intratendinous signal intensity increase of the plantar fascia could be observed. Compared to the control group (mean thickness 3.3 mm) the plantar fascia showed significant thickening in the thirty MR positive patients (mean thickness 7.7 mm). Conclusion: Planter fasciitis is common in high heel using women. Besides thickening of the plantar fascia, intratendinous signal intensity increase and peritendinous edema close to the plantar fascia are characteristic signs of plantar fasciitis on MRI. Both signs can reliably be seen on STIR sequences only.