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Chronic Plantar Fasciitis: Acute Changes in the Heel after Extracorporeal High-Energy Shock Wave Therapy—Observations at MR Imaging¹

¹ From the Mallinckrodt Institute of Radiology (F.Z., K.T.B.) and Department of Orthopedic Surgery (J.E.J., C.B.H.), Washington University School of Medicine, 510 S Kingshighway Blvd, CB 8131, St Louis, MO 63117. Received October 10, 2003; revision requested December 30; final revision received March 31, 2004; accepted May 12. Address correspondence to K.T.B. (e-mail: baet@mir.wustl.edu).

View larger version (172K): [in a new window]   Figure 1. Sagittal (4000/108) (left) and coronal (4000/108) (right) T2-weighted fat-saturated fast SE images of the hind foot before (top) and after (bottom) ESWT. Mild soft-tissue and perifascial edema (arrow) and thickened plantar fascia (arrowhead) are clearly depicted on the pre-ESWT images; the perifascial and surrounding soft-tissue edema increased after ESWT. Thickness of the fascia was little affected (9.0 mm before and 9.2 mm after ESWT on sagittal and 9.1 mm both before and after ESWT on coronal images).

View larger version (107K): [in a new window]   Figure 2. Sagittal T2-weighted fat-saturated fast SE images (4000/108) show the calcaneus bone marrow edema (arrow) at the insertion site before (left) and after (right) ESWT. There was no detectable change in bone marrow edema.

View larger version (104K): [in a new window]   Figure 3. Sagittal T1-weighted SE images (500/13) show the calcaneus bone spur (arrow) before (left) and after (right) ESWT. No apparent interval change was observed.

View larger version (213K): [in a new window]   Figure 4. Sagittal T2-weighted fat-saturated fast SE (4000/108) (left) and T1-weighted SE (500/13) (right) images of the hind foot before (top) and after (bottom) ESWT. The signal intensity (arrowhead on T2-weighted and arrow on T1-weighted images) of the plantar fascia was little affected by the therapy.