MRI findings in the heel pain

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MRI findings in the heel pain

Poster No.: C-1992

Congress: ECR 2016

Type: Educational Exhibit

Authors: _{C. FONTES}1

, A. A. S. M. D. Santos2, H. Shimidu3, M. A. saad3, L. Nunes3, D. C. Alexandre4, E. Casagrande3, S. Bustamante3;

1

NITEROI - RJ/BR, 2Niterói - Rio de Janeiro, RJ/BR, 3Niterói - Rio de Janeiro/BR, 4Niterói, RJ/BR

Keywords: Trauma, Outcomes, Image verification, Perception image,

Outcomes analysis, Observer performance, MR, Musculoskeletal system

DOI: 10.1594/ecr2016/C-1992

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• The aim of this study is to evaluate the most frequent findings in

examinations of patients with chronic pain in the heel, correlating with the findings in MRI.

Background

• Chronic pain in the heel is a common clinical complaint in adult patients and may interfere with the patient's routine activities, and to be disabling.

• Even performing a detailed clinical examination and anamnesis, its necessary choose a method of examination by appropriate imaging able to perform the correct final diagnosis, since many diseases can cause this kind of pain. • In addition to clinical history and physical examination, diagnostic imaging

methods are needed for accurate diagnosis, because chronic pain calcaneal has a large number of pathologies, and imaging tests play a key role in the diagnosis and treatment.

• Plain radiography is still a requested method for initial evaluation for its ease and low cost.

• MRI allows to provide accurate diagnosis, determining treatment, and also allows you to monitor the response to therapy.

• The MRI offers superior softtissue

• contrast resolution and can be helpful in diagnosis as well as in presurgical planning.

Findings and procedure details

• We present a review of causes of pain in the heel in adult patients, correlating with the clinical and imaging findings in MRI.

• The studies were evaluated by two radiologists with expertise in the musculoskeletal system, which reached consensus.

• The main MRI findings were : Bone and soft tissue injuries as well as plantar fasciitis, fibromatosis and trauma cases.

• Findings in the posterior heel ( FIGS 1-16):

• Among the various causes of pain in the heel, such as neurological

diseases, arthritis, traumatic, neoplastic, infectious and vascular, we have the mechanical origin as more frequent, being the most affected sites the posterior heel and plantar surface.

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• Findings in plantar surface (FIGS 17-21). • Findings in medial region (FIG. 22).

• Findings in superior region (FIGS 23-24).

• Other findings ( FIGS 25-33)

Images for this section:

Fig. 1

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© Radiology, HUAP/UFF (Federal Fluminense University) - Niterói - Rio de Janeiro/BR

Fig. 3: FIGURES 3,4.

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Fig. 4: FIGS 5,6

Fig. 5: FIGS 7,8

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Fig. 7: FIG 11

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Fig. 8: FIG 12.

Fig. 9: FIG 13,14

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Fig. 11: FIG 16.

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Fig. 12: FIG. 17.

Fig. 13: FIG.18, 19

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Fig. 15: FIG 21

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Fig. 16: FIG.22

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Fig. 18: FIG 24

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Fig. 20: FIG 26

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Fig. 22: FIG 28,29

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Fig. 24: FIG 31

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Conclusion

• MRI is effective in the evaluation of patients with pain in the heel may be obtained sure diagnoses.

• MRI of the calcaneus consists of screening method for image easy to perform, causing no discomfort to the patient, and with few indications for implementation phase with intravenous contrast.

Personal information

References

1 Resnik D, Kang HS, Pretterklieber ML. Internal Derangements of Joints. 2nd ed. Philadelphia: Saunders Elsevier; 2007.

2 Kaplan PA, Helms CA, Dussault R, et al.Ressonância Magnética Músculo-esquelética.1ed.Rio de Janeiro: Guanabara Koogan; 2003.

3 Stoller DW, Tirman PFJ, Bredella MA , et al. Diagnostic Imaging - Orthopaedics. 1st ed.Salt Lake City: Amirsys; 2004.

4 Javier Arnaiz J, Piedra T, Lucas EM, et al.Imaging Findings of Lower Limb Apophysitis.AJR 2011;196:W316-W325.

5 The Diagnosis and Treatment of Heel Pain. A clinical practice guideline revision 2010.Thomas JL, Christensen JC, Kravitz SR, et al. J Foot Ankle Surg 2010;49:S1-S19.