In a recent edition of Radiological Medicine there is a new study that investigated the use of a weightbearing MRI to assess those with plantar fasciitis. They were able to report that the changes in the MRI signal that was associated with plantar fasciitis when compared by blinded examiners in those without plantar fasciitis. Unlike the usual ultrasound finding, the thickness of the plantar fascia was reduced due to stretching in the weightbearing position compared to the supine position. This is an importantt observation given the emphasis  that gets put on the thickness of the plantar fascia with ultrasound measurement which is done non-weightbearing. The important finding in this study was of 15 cases that they looked at, 4 had partial tears of the plantar fascia visible on the weightbearing MRI. This has implications for sports medicine as a number of the cases of plantar fasciitis that are seen, may infact be partial tears.

Gout is not a common cause of heel pain but gout can affect the subtalar joint, causing pain in the rearfoot. The urate crystals can also deposit in the plantar soft tissue and mimic plantar fasciitis. The differential diagnosis is usually difficult as both can mimic other symptoms. For gout and heel pain, considers a course of colchicine to help in the diagnosis.