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The role of bone scintigraphy and plain radiography in intractable plantar fasciitis

The objective of this study was to assess the role of bone scintigraphy and plain film radiography in intractable plantar fasciitis. The bone scintigrams, radiographs and clinical histories of 33 patients with chronic plantar fasciitis were reviewed. These patients were refractory to conservative treatments and were being considered for surgical plantar fascia release. Twenty-eight patients had increased uptake on scintigraphy at the medial calcaneal tubercle, while a plantar spur was seen in 21 patients. Seventy-five percent of patients with increased uptake had a calcaneal spur; 95% of patients with a spur had increased uptake on scintigraphy. It would appear that plantar calcaneal spurs are more prevalent in this group of patients than in the general population and, although they may not be the primary cause of pain, they may predispose to it. Scintigraphy was helpful in patients without a spur or with atypical symptoms or signs. It did not provide any further information on the group of patients with a spur.