Plantar fibromatosis can be seen in both children and adults, although there is a recognised male predilection (M:F of 2:1).
Nodules or masses of plantar fibromatosis are typically located in the middle to the medial aspect of the plantar arch and may extend to involve the skin or deep structures of the foot. Lesions may be symptomatic because of a mass effect or invasion of adjacent muscles or neurovascular structures. In contrast to Dupuytren disease, flexion deformities usually do not occur 9.
Plantar fibromatosis is associated with other fibroproliferative disorders such as:
- Dupuytren disease (also known as palmar fibromatosis) is seen in ~40% (range 10-65%) of patients
- Peyronie disease
Unfortunately, exact aetiology of plantar fibromatosis is not well understood 4.
Often seen as a hypo to mixed echogenicity 3 discrete, fusiform, multinodular thickening of the plantar fascia located separately to the calcaneal insertion 1.
Again typically seen as a relatively well-defined region of multinodular thickening about the inferior margin of the plantar fascia.
- T1: iso to low signal compared with muscle 1,2
- T1 C+ (Gd): demonstrates variable contrast enhancement 4
- T2: low to intermediate signal compared with muscle 1,2
Treatment and prognosis
Initially orthotics and local steroid injection are the treatment of choice. Radiotherapy is the most efficient with the least recurrence rate 10. Local excision with a wide margin is the definitive treatment for painful or disabling lesions, but recurrences are common 11.
History and etymology
Plantar fibromatosis is sometimes referred to as Ledderhose disease after Georg Ledderhose (1855-1925), German surgeon, who first described it in 1894 7,12.
- 1. Griffith JF, Wong TY, Wong SM et-al. Sonography of plantar fibromatosis. AJR Am J Roentgenol. 2002;179 (5): 1167-72. AJR Am J Roentgenol (full text) - Pubmed citation
- 2. Narváez JA, Narváez J, Ortega R et-al. Painful heel: MR imaging findings. Radiographics. 20 (2): 333-52. Radiographics (full text) - Pubmed citation
- 3.Pham H, Fessell DP, Femino JE et-al. Sonography and MR imaging of selected benign masses in the ankle and foot. AJR Am J Roentgenol. 2003;180 (1): 99-107. AJR Am J Roentgenol (full text) - Pubmed citation
- 4. Theodorou DJ, Theodorou SJ, Farooki S et-al. Disorders of the plantar aponeurosis: a spectrum of MR imaging findings. AJR Am J Roentgenol. 2001;176 (1): 97-104. AJR Am J Roentgenol (full text) - Pubmed citation
- 5. Lee JC, Thomas JM, Phillips S et-al. Aggressive fibromatosis: MRI features with pathologic correlation. AJR Am J Roentgenol. 2006;186 (1): 247-54. doi:10.2214/AJR.04.1674 - Pubmed citation
- 6.Quinn SF, Erickson SJ, Dee PM et-al. MR imaging in fibromatosis: results in 26 patients with pathologic correlation. AJR Am J Roentgenol. 1991;156 (3): 539-42. AJR Am J Roentgenol (abstract) - Pubmed citation
- 7. Ledderhose G (1894). "Über Zerreisungen der Plantarfascie". Arch Klin Chir 48: 853–856.
- 8. Dinauer PA, Brixey CJ, Moncur JT et-al. Pathologic and MR imaging features of benign fibrous soft-tissue tumors in adults. Radiographics. 27 (1): 173-87. doi:10.1148/rg.271065065 - Pubmed citation
- 9. Hougeir FG, Elston DM, Plantar Fibromatosis Clinical Presentation. Medscape. updated 14th May 2014. emedicine link
- 10. Schurer, A., Manley, G., Wach, W. (2016) International Patient Survey (Part 2: Ledderhose Disease) in Werker, P., Dias, J., Eaton, C., Reichert, B., Wach, W. (ed) (2016) Dupytren Disease and related diseases Switzerland: Springer pp 371-5
- 11. Van der Veer, W.M., Stijn, M., de Gast, A., Niessen, F. (2008) Recurrence of Plantar Fibromatosis after Plantar Fasciectomy: Single-Center Long-Term Results Plastic and Reconstructive Surgery 122 (2) pp 486-91
- 12. Al Aboud AK. Eponyms in dermatology literature linked to fi bromatoses. Our Dermatol Online. 2018;9(1):108-109. DOI: 10.7241/ourd.20181.37. http://www.odermatol.com/odermatology/20181/37.Eponyms-AlAboudK.pdf