5-Step Protocol for a Targeted Ultrasound of a Plantar Fibroma in the Foot

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5-Step Protocol for a Targeted Ultrasound of a Plantar Fibroma in the Foot

By Learn MSK Sono FEATURING Jamie Bie, RMSKS, RVT, RDMS

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June 1, 2023

What pathology comes to mind when your patient presents with a palpable lump on the ...
read more ↘ arch of their foot?

This finding is typically consistent with a plantar fibroma, which is a benign fibrous nodule embedded in the plantar fascia. The plantar fascia is superficial in the arch of the foot, making it easy to feel these growths. They may eventually cause discomfort when walking. What images should be obtained for this targeted foot exam?

Here is a simple 5-step protocol for imaging plantar fibromas in the foot:
1. Locate and image the fibroma in the long and short axis using grayscale imaging.
2. Label the surrounding structures in the image to document the location of these lesions. Fibromas are most commonly found continuous with the central cord of the plantar fascia, but can also be found along the medial cord.
3. Measure the fibroma in the long and short axis (3 images).
4. Use power doppler to assess the fibroma for any vascularity present.
5. Use the extended field of view feature to measure the distance of the fibroma from the calcaneus, where the plantar fascia inserts.

When multiple fibromas are present, number each lump palp 1, palp 2, etc… You may also incidentally come across these nodules during your plantar fascia protocol, in which case they should be assessed and documented in the same way they are for a targeted exam.
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