Ankle and Foot 47 - Department of Radiology - University of ...

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2302 VII Imaging of the Musculoskeletal System D E F G Figure 47-105, cont’d Bone scan images, both-feet-on-detector (D) and lateral (E) views, show increased activity in the right calcaneal tuberosity. Incidentally noted is normal activity in the distal tibial physis (arrowheads) in this skeletally immature patient. Midsagittal T1-weighted (F) and T2-weighted fat-suppressed (G) images show the characteristic well-defined black line (arrowheads) of a calcaneal stress fracture, as well as edema in the surrounding bone marrow. Ch047-A05375.indd 2302 9/9/2008 5:36:02 PM
47 Ankle and Foot 2303 47 A B C D E Figure 47-106. Plantar fasciitis in a 52-year-old with chronic bilateral heel pain. The left (A to C) and right (D to F) hindfeet were scanned individually. A, Sagittal T1-weighted image reveals thickening of the plantar fascia (white arrows). B, The corresponding sagittal inversion recovery (IR) image reveals edema (white arrowhead) deep to the plantar fascia (white arrow). Open arrow points to OS trigonum. C, Coronal T2- weighted fat-suppressed image demonstrates a line of fluid (white arrowhead) as well as some focal bone marrow edema (black arrowhead) deep to the origin of the plantar fascia (white arrow). (“med” and “lat” represent the medial and lateral sides of the image, respectively.) Incidentally seen is a normal os trigonum (open arrow in A to C) with bone marrow signal isointense to the normal bone marrow in the other bones. D, Sagittal T1-weighted image of the contralateral right foot also demonstrates a thickened plantar fascia (arrows). The calcaneal bone marrow edema is less conspicuous than on more fluid-sensitive sequences. E, The corresponding IR images reveal extensive bone marrow edema along the plantar portion of the calcaneus (arrowheads). F, Coronal T2-weighted fat-suppressed image shows the bone marrow edema (white arrowhead) radiating from the medial-plantar surface of the calcaneus, at the origin of the plantar fascia. F Ch047-A05375.indd 2303 9/9/2008 5:36:03 PM
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Ankle and Foot 47 - Department of Radiology - University of ...

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