Plantar Fibromatosis

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  • Plantar fibromatosis also known as Ledderhose disease is a rare benign fibroproliferative disorder of the plantar fascia
  • A plantar “fibroma” is usually slow growing and typically measures less than an inch in size; more invasive rapid-growing and multi-planar “fibromas” are considered plantar fibromatosis.
  • Patients usually present with pain or a lump in the sole of the foot
  • Routine foot MR includes T1 TSE axial T2 STIR axial T1 TSE coronal T2 STIR coronal T2 STIR sagittal and T1 TSE sagittal
  • On MR imaging plantar fibromatosis appears as a well-defined oval nodule that is contiguous with the plantar fascia and has low signal intensity on T1-weighted sequences and low-to-intermediate signal intensity on T2-weighted sequences
  • MR imaging is excellent at showing the deep extension found in advanced aggressive forms of plantar fibromatosis but the availability and low cost of sonography make it the imaging technique of choice for most patients
  • Typical position is at the proximal aspect of the medial cord at the distal-proximal locus – base of 1st tarso-metatarsal junction
  • Plantar fasciitis is caused by overuse and trauma to the arch of the foot while researchers believe that the primary cause of plantar fibromatosis is rooted in genetics; it is possible to have both plantar fasciitis and plantar fibromatosis at the same time
  • The differential diagnosis of a mass on the sole of the foot includes plantar fasciitis (the most frequent lesion of a swelling of the plantar fascia) leiomyoma rhabdomyosarcoma neurofibroma and liposarcoma; clinical radiological and histological correlation helps in confirming a diagnosis
  • 33% are bilateral
  • A higher incidence of Dupytren’s contracture is found in patients with plantar fibromatosis
  1. English C Coughlan R Carey J Bergin D. Plantar and palmar fibromatosis: characteristic imaging features and role of MRI in clinical management. Rheumatology 2012; 51(6):1134–1136

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