Clinical concern includes plantar fasciitis or plantar fascia tear. Next imaging study. Bone Scan Foot with SPECT or SPECT/CT SPECT/CT has been found to be of use when investigating heel pain with increased specificity when compared to bone scintigraphy alone, because of the improved anatomic localization of metabolic activity. Despite the anatomic and functional advantages of SPECT/CT, MRI and high-frequency US remain the most frequently used imaging modalities in patients with heel pain [50]. A characteristic pattern of abnormal uptake on 3-phase bone scintigraphy has been proven helpful to differentiate plantar fasciitis from calcaneal stress or avulsion fractures [51]. There is no relevant literature to support the routine use of nuclear medicine studies to diagnose plantar fascial tears. Chronic Foot Pain CT Foot There is no relevant literature to support the routine use of CT in the evaluation of a patient with clinical suspicion of pathology of the plantar fascia. MRI Foot MRI allows accurate characterization of the plantar fascia and adjacent soft-tissues and bones, and several imaging findings have been described in patients with plantar fasciitis and partial or complete tears of the plantar fascia on MRI [52]. Given that, some of the findings in patients with plantar fasciitis are nonspecific; these findings can also be seen in asymptomatic patients. MRI should always be correlated with clinical symptoms to avoid overcalling plantar fasciitis. Although no significant differences have been found in plantar fascia thickness on US and MRI, MRI is currently considered the most sensitive imaging study in the diagnosis of plantar fasciitis [53]. There is no relevant literature supporting the routine use of contrast in the diagnosis of plantar fasciitis or tears. US Foot US has shown good sensitivity (80%) and specificity (88%) in the diagnosis of plantar fasciitis when compared to MRI [54].
Chronic Foot Pain. Clinical concern includes plantar fasciitis or plantar fascia tear. Next imaging study. Bone Scan Foot with SPECT or SPECT/CT SPECT/CT has been found to be of use when investigating heel pain with increased specificity when compared to bone scintigraphy alone, because of the improved anatomic localization of metabolic activity. Despite the anatomic and functional advantages of SPECT/CT, MRI and high-frequency US remain the most frequently used imaging modalities in patients with heel pain [50]. A characteristic pattern of abnormal uptake on 3-phase bone scintigraphy has been proven helpful to differentiate plantar fasciitis from calcaneal stress or avulsion fractures [51]. There is no relevant literature to support the routine use of nuclear medicine studies to diagnose plantar fascial tears. Chronic Foot Pain CT Foot There is no relevant literature to support the routine use of CT in the evaluation of a patient with clinical suspicion of pathology of the plantar fascia. MRI Foot MRI allows accurate characterization of the plantar fascia and adjacent soft-tissues and bones, and several imaging findings have been described in patients with plantar fasciitis and partial or complete tears of the plantar fascia on MRI [52]. Given that, some of the findings in patients with plantar fasciitis are nonspecific; these findings can also be seen in asymptomatic patients. MRI should always be correlated with clinical symptoms to avoid overcalling plantar fasciitis. Although no significant differences have been found in plantar fascia thickness on US and MRI, MRI is currently considered the most sensitive imaging study in the diagnosis of plantar fasciitis [53]. There is no relevant literature supporting the routine use of contrast in the diagnosis of plantar fasciitis or tears. US Foot US has shown good sensitivity (80%) and specificity (88%) in the diagnosis of plantar fasciitis when compared to MRI [54].