Answer for BIR CoW 15 May 2022
Plantar fibromatosis
Findings
T1 iso to hypointense, T2 intermediate intensity, enhancing nodule in the plantar medial aspect of the foot. No deep extension or involvement of the skin.
Discussion
Plantar fibromatosis is a superficial fibromatosis due to benign proliferation of fibroblasts. Nodules or masses are typically seen on the non-weight-bearing plantar aponeurosis, predominantly on the medial side of the plantar arch. Nodules can be multiple in 35% and bilateral in 20-50%. It may involve the overlying skin or underlying deep structures of the foot. The nodules or masses are usually iso to hypointense relative to skeletal muscle and show variable enhancement. The signal intensity and enhancement depend on the maturity of the lesion. Immature lesions generally tend to enhance more and chances of recurrence are high, while the mature lesions tend to show poor enhancement with contrast and the chance of recurrence is less. The treatment of plantar fibromatosis is often conservative and consists of footwear modifications. Surgical resection is reserved for large symptomatic lesions.
Findings
T1 iso to hypointense, T2 intermediate intensity, enhancing nodule in the plantar medial aspect of the foot. No deep extension or involvement of the skin.
Discussion
Plantar fibromatosis is a superficial fibromatosis due to benign proliferation of fibroblasts. Nodules or masses are typically seen on the non-weight-bearing plantar aponeurosis, predominantly on the medial side of the plantar arch. Nodules can be multiple in 35% and bilateral in 20-50%. It may involve the overlying skin or underlying deep structures of the foot. The nodules or masses are usually iso to hypointense relative to skeletal muscle and show variable enhancement. The signal intensity and enhancement depend on the maturity of the lesion. Immature lesions generally tend to enhance more and chances of recurrence are high, while the mature lesions tend to show poor enhancement with contrast and the chance of recurrence is less. The treatment of plantar fibromatosis is often conservative and consists of footwear modifications. Surgical resection is reserved for large symptomatic lesions.
Note:
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
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Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!