Plantar Fibromatosis

Aka: Plantar Fibromatosis, Plantar Fibroma

1. See Also
   1. Plantar Fasciitis
2. Definitions
   1. Plantar Fibromatosis (Plantar Fibroma)
      1. Fibrous proliferation of the plantar fascia and plantar aponeurosis
      2. Similar to Dupuytren's Contracture of palm
3. Risk Factors
   1. Dupuytren Contracture
   2. Peyronie Disease
4. Symptoms
   1. Slow enlargement of a painless Subcutaneous Nodule
   2. Eventually becomes tender and painful with walking or prolonged standing
5. Signs
   1. Palpable Nodule or thickening of the plantar fascia
   2. Involves medial half of middle of plantar fascia
   3. Contractures rarely occur
   4. Bilateral involvement in 20 to 50% of cases
6. Differential Diagnosis
   1. Plantar Fasciitis
7. Imaging
   1. Ultrasound
      1. Hypoechoic to isoechoic fusiform Nodules
   2. MRI
      1. Well defined mass with similar intensity to Muscle on T1 imaging
      2. Broad base at the superficial fascia
8. Management
   1. Molded Orthotic
      1. Allows transfer of weight away from Nodule
   2. Intralesional Corticosteroid Injection
   3. Surgery: Subtotal fasciectomy with wide excision
      1. Indicated when weight bearing becomes painful
      2. Often recurs after excision
9. References
   1. Achar (2022) Am Fam Physician 105(6): 602-12 [PubMed]
   2. Young (2018) Orthop Res Rev 11:1-7 [PubMed]