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Doctors - Can you interpret these MRI results?

Posted by DavidW on 8/10/04 at 06:55 (157355)

Had an MRI earlier this year, as directed by by 2nd Podiatrist. I have pain only when on my feet for more than 15 minutes (2+ years), never in the AM, no pain to the touch, pain subsides with rest.

During my last Podiatrist visit, I asked to review the results, but he did not feel it was necessary. The text of the MRI report is as follows:

TECHNIQUE: A noncontrast MRI left foot was requested and performed. Examination was performed with sagittal and axial T1 and STIR, and coronal T1 and fat-suppressed T2 images. Patient did not indicate to us the presence of any localized soft tissue lumps.

FINDINGS: There is a small focus of increased signal at the level of the proximal plantar fascia adjacent to the calcaneus, on sagittal T1 images, without abnormally increased signal on corresponding STIR images. This could represent a normal finding, or very mild plantar fascitis. No discrete-obvious plantar fibroma is identifited. Note is made that contrast-enhanced fat-suppressed T1 imaging may be more sensative for detecting small plantar fibromas. If suspected clinically, then follow-up contrast-enhanced imaging suspected.

Evaluation of the osseous structures shows a possible small, subchondral cyst, measuring about 4 or 5 mm, at the level of the distal aspect proximal phalanx great toe, noted on axial STIR image number 7. Osseous structures appear otherwise unremarkable.

IMPRESSION: Possible very mild proximal plantar fascitis. No obvious plantar fibroma identified. Approximately 5 mm, round signal hyperintensity distal aspect proximal phalanx great toe. This could represent a small degenerative or posttraumatic subchondral cyst, or possibly volume averaging from joint fluid. Radiographic correlation suggested.

Re: Doctors - Can you interpret these MRI results?

Dr.David Wander on 8/10/04 at 07:35 (157356)

The results seem to be pretty clear. There is mild plantar fasciitis, with no mentioned tear of the plantar fascia and no bone marrow edema to indicate a stress fracture of the calcaneus. If a fibroma is suspected by your doctor, the test should be repeated with contrast (I.V. injection).

There is a possible cyst in one of the bones of your large toe that may be of no significance. This should be correlated with symptoms and with traditional x-rays for follow up.

Just because an MRI does not show any obvious pathology at the heel area other than 'mild' plantar fasciitis, doesn't mean that your pain isn't present or that you don't have heel pain syndrome. Your doctor must treat your foot, not your x-rays.

Re: Doctors - Can you interpret these MRI results?

DavidW on 8/10/04 at 09:02 (157368)

Thank you very much for your comments!