Magnetic resonance imaging of stress injury of the cuneiform bones in patients with plantar fasciitis.

OBJECTIVE: The authors reported the magnetic resonance (MR) appearance of stress fractures of the cuneiform bones in patients with plantar fasciitis and performed a review of the literature on stress fractures associated with plantar fasciitis.

MATERIALS AND METHODS: The authors performed a retrospective review of their experience with 5 cases of cuneiform stress fractures and associated plantar fasciitis. The medical records and MR examinations were reviewed. A literature search was performed on the PubMed search engine.

RESULTS: There were 5 patients (1 man and 4 women) with stress fractures of at least 1 cuneiform bone. Patients' age ranged from 41 to 77 years, and their average weight was 212 lb. All patients had heel pain and either midfoot or lateral foot pain. There were 2 intermediate, 1 medial, and 3 lateral cuneiform stress fractures seen on MR imaging in these 5 patients. Two of these patients had undergone plantar fasciotomy, and all 5 had been treated with steroid injections.

CONCLUSION: Plantar fascia injury, changes in gait, large body habitus, and excessive or new onset of exercise regimens are all potential causes of cuneiform stress fractures. Although the incidence of cuneiform stress fractures is extremely rare, they may occur in patients with plantar fasciitis.