MRI study was conducted on 40 patients with a mean age of 40 ±7.2 years.
Twenty control volunteers,
age-matched and healthy also were underwent the same protocol of MRI study.
All our 40 patients were using high heels as the following criteria : length of the heel not less that 2.5 inches,
a duration mean of 4 hours /day,
5 days/ week,
with average body mass index 25-30%.
The control group were not wearing high heel & had no painful heel.
Patients with the following criteria were excluded from our study: over weight,
abnormal shape of the foot as high arched foot,
and sportive runners.
All the examined patients were laboratory investigated for blood glucose level,
rheumatoid factor,
uric acid & ESR.
Also plain x-ray foot was done in different direction for exclusion of other causes of painful heel.
Four patients were suspected to have tarsal tunnel syndrome & nerve conduction study was done to exclude this cause.
Clinical orthopedic examination revealed heel pain with the following criteria : the pain starts with initial weight bearing after a period of time & increases upon rising in morning ,
on palpation ,
tenderness was at the inferior aspect of the heel ,
MR images were obtained with a 1.5-T superconducting MR imager (Signa; GE Medical Systems,
Milwaukee,
Wis) with a 5-inch (13-cm) standard small flexible surface coil (Flex Coil;Medical Advances,
Milwaukee,
Wis).
Routine ankle MR imaging was performed in the axial,
coronal,
and sagittal planes.
The foot is imaged in the oblique coronal plane,
oblique axial plane,
and oblique sagittal plane .T1-weighted (repetition time msec/echo time msec = 600/20) and T2-weighted (2,000/20,80) Fat suppression techniques ,
fat-suppressed proton-density–weighted imaging & short-inversion-time inversion recovery (STIR) sequences (1,500/20; inversion time msec = 100–150).
The patients were in supine position with the foot in about 20° of plantar flexion,
this is specially helpful for the following reasons: it accentuates the fat plane between the tendons specially the peroneal tendons & decreases the effect of the magic angle.
The imaging data were reviewed by two radiologists (with more than five years of experience) blinded of the patients clinical pictures; and then they nearly reached a consensus opinion.
The regional ethics committee approved the study and written informed consent were obtained from all participants.