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Painful Heel: MR Imaging Findings¹

¹ From the Department of CT and MRI-Institut de Diagnòstic per la Imatge (J.A.N., R.O., C.A., A.S., E.A.) and the Department of Rheumatology (J.N.), Hospital Duran Reymals, Ciutat Sanitària y Universitària de Bellvitge, Autovía de Castelldefels km 2'7, L'Hospitalet de Llobregat, 08907 Barcelona, Spain. Recipient of a Certificate of Merit award for a scientific exhibit at the 1998 RSNA scientific assembly. Received February 25, 1999; revision requested April 7 and received May 24; accepted May 24. Address reprint requests to J.A.N. (e-mail: cvalls@csub.scs.es).

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 disorders are classified on the basis of anatomic origin and predominant location of heel pain to foster a better understanding of this complaint. The disorders include plantar fascial lesions (fasciitis, rupture, fibromatosis, xanthoma), tendinous lesions (tendinitis, tenosynovitis), osseous lesions (fractures, bone bruises, osteomyelitis, tumors), bursal lesions (retrocalcaneal bursitis, retroachilleal bursitis), tarsal tunnel syndrome, and heel plantar fat pad abnormalities. With its superior soft-tissue contrast resolution 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 of MR imaging findings and correlation of these findings with patient history and findings at physical examination can suggest a specific diagnosis in most cases. The majority of patients with heel pain can be successfully treated conservatively, but in cases requiring surgery (eg, plantar fascia rupture in competitive athletes, deeply infiltrating plantar fibromatosis, masses causing tarsal tunnel syndrome), MR imaging is especially useful in planning surgical treatment by showing the exact location and extent of the lesion.

Index Terms: Ankle, anatomy, 46.92 • Ankle, MR, 46.12141, 46.121413, 46.121415, 46.121416 • Bones, infection, 46.21 • Bursitis, 46.251 Calcaneus, fractures, 4642.41 • Foot, anatomy, 46.92 • Foot, MR, 46.12141 • Tendinitis, 46.253 • Tenosynovitis, 46.252

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