Presentation
Local foot pain of recent onset.
Patient Data
Small elongated formation, located in soft tissues in the plantar portion of the second intermetatarsal space, at the level of the metatarsal heads. A punctate image hyperintense on T1 and isointense on DP is identified in the central portion of the lesion. Contrast enhanced T1-weighted sequence shows intraluminal filling defect and perivascular enhancement.
Annotated images.
Case Discussion
Generally, the lateral plantar vein is most affected (in 96% of cases), followed by the middle plantar vein.1
Several causal factors are speculated, among them trauma, paraneoplastic syndromes, post-operative conditions, thrombophilias, use of contraceptive drugs, immobilization and HIV infection. However, most cases are classified as being idiopathic
Although relatively rare, plantar vein thrombosis should be considered in the differential diagnostic list of plantar pain, particularly in the appropriate clinical setting.
First, we must consider the most common causes of pain, such as plantar fasciitis, tendinous involvement, bursitis, Morton’s neuroma, stress fractures, sesamoiditis and ganglion cysts.
There is no defined treatment.