X-ray of the heel (calcaneus): spur, description, treatment
A heel spur is a common disease of the foot. It occurs for many reasons – incorrect footwear, joint disease or professional activities, but most often because of flat feet. The disorder plantar fasciitis, or calcaneal spur, is characterized by severe heel pain in the morning and after a rest, when a man arose from his bed, relies on the sole. The disease develops in 18% of women and runners.
The main diagnostic symptom of heel spur is an x – ray of the calcaneus, which revealed a heel spur. Let’s learn, how is a heel spur. Consider radiological signs of heel spurs.
How do x-rays of the foot?
Depending on the suspected pathology x-ray making in two ways:
- In the supine position with bent knees feet, while the feet rested in the table.
- When the x-ray load of the patient stands on one leg and rests his weight on the examined leg.
Projection of the calcaneus the doctor chooses depending on the suspected pathology. Special preparation for x-ray not required, but the foot should not be metallic objects, which can distort the quality of the x-ray.
That detects the x-rays of the foot?
The largest bone of the foot is the talus. When upright and walking, it carries the greatest load. On radiographs, the bones can be seen:
- flat feet;
- heel spur;
- malignant and benign bone and joint tumors;
- dislocations, subluxations;
X-rays helps to detect the disease and to carry out differential diagnostics with other diseases.
Radiological signs of spurs
Heel spur is a bony growths on the surface of the talus, often in the region of the hill. They expand due to flat feet, physical activity, irrational shoes or inflammatory diseases of the foot. On the radiograph of the heel spur looks like a hook-shaped or awl-shaped growths in the posterior or bottom surface of the tuber.
These characteristics allow to distinguish the spur from gout, osteomyelitis or arthritis.
Clinically defined change in gait, where the center torso is shifted on the forefoot and toes. In the projection of the spur is visible on the skin blisters. The main complaints of patients – severe heel pain in the morning by relying on the foot. Some time after promazyvanija pain decreases.
Alternative diagnosis of plantar fasciitis
In the diagnosis of heel spur used magnetic resonance imaging (MRI). This method examines the state of the bones, ligaments, muscles and fascia of the foot. MRI scanning reveals thickening of the fascia at disease to 6-10 mm. In the normal fascia not thicker than 4 mm.
MRI is used for differential diagnosis of cartilage damage, Achilles tendon and heel spurs. For research use ultrasonography of the foot, but it is used more often for monitoring during treatment.
Interpretation of the picture of the foot
Obtained in the study images, the radiologist decodes immediately after the procedure. Radiograph allows to find out the cause of the pain, to determine the nature of the pathological process. When diagnosis of plantar fasciitis radiologist gives a description of the image.
In conclusion, the doctor noted the presence of osteophytes, indicating its length and location. Usually, osteophytes are visible in the projection of the upper edge of the rear tuberosity of the talus.
Radiographic signs of fracture of the talus
Fracture of the talus that occurs during a fall from a height or car accident. On x-ray is determined by the displacement of bones and fragments. Is determined by the length of the fracture. For diagnostic purposes, make x-rays in two projections, lateral and axial.
During the inspection noted a hematoma and soreness when pressing on the heel. The mobility of the foot is limited.
Radiographic signs of cyst of the talus
Cyst of the talus for a long time does not manifest any clinical signs and are detected accidentally on x-ray. Cyst often develops as a result of permanent foot injuries in athletes, including in children. When pain in the heel during physical exertion or when walking there is swelling of the foot.
A cyst is detected in the axial projection. On x-ray it looks like a oval formation. Cysts occur due to pathological fractures of the talus, limiting the movement of the foot.
Treatment of plantar fasciitis
Conservative treatment of plantar fasciitis and heel spur is long and requires great patience from the patient. The main impact of the therapeutic measures are directed against the inflammatory process in the fascia, and stretching for the prevention of new fractures. Methods of treatment:
- medication includes the use of nonsteroidal anti-inflammatory drugs (NSAIDs) in the form of ointments, gels, poultices and pills;
- sure wearing hard orthopedic insoles and heel cups allows for correction of the arch of the foot and reduce pressure on the plantar fascia;
- physiotherapy and therapeutic exercise (physical therapy);
In severe of plantar fasciitis use the laser treatment, shock-wave therapy (UFT). When conservative treatments do not have effect, blockage of the area of the heel spur hormonal therapy – Kenalog, Diprospan, Hydrocortisone.
Summing up, we emphasize in the diagnosis of diseases of the foot continues to apply informative and accessible method – radiography. It reveals diseases and their nature, fractures, cysts and malignant tumors. In doubtful cases the use of more accurate diagnostic techniques: ultrasound, MRI (magnetic resonance imaging) and CT (computed tomography).