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Plantar fibroma - Foot and Ankle

Summary

Plantar fibromatosis is a non-encapsulated thickening and proliferation of the central and medial bands of the plantar fascia.

Patient's present in their second third and fourth decade.
Most patients are asymptomatic, but some have activity related pain. One third to half of the patients have bilateral nodules.
The lesion appears as a poorly defined area of thickening of the planter fascia with low signal intensity on both T1 and T2 weighted sequences.
Initial management should consist of shoe modifications and pain medication.
Complete Information on this Tumor
Introduction and Definition: 

Plantar fibromatosis is a non-encapsulated thickening and proliferation of the central and medial bands of the plantar fascia. This lesion is histologically similar to Dupuytren's contracture, for which a clinical study of non-operative treatment with clostridium-derived collagenase enzyme is currently underway.

Incidence and Demographics: 
Patient's present in their second third and fourth decade.
Symptoms and Presentation: 

Most patients are asymptomatic, but some have activity related pain. One third to half of the patients have bilateral nodules.

X-Ray Appearance and Advanced Imaging Findings: 
The MRI signal characteristics of the lesion are characteristic and allow this lesion to be differentiated from other more worrisome problems. The lesion appears as a poorly defined area of thickening of the planter fascia with low signal intensity on both T1 and T2 weighted sequences.
Treatment Options for this Tumor: 
Initial management should consist of shoe modifications and pain medication. Surgical removal is reserved for large lesions that are causing significant disability that have failed a well-documented course of non-operative care. Aggressive resection with a wide margin is necessary to avoid recurrence, but may associated with significant complications.
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