Typical looking P Fibroma central and medial cord. Looks like P Fibroma of the distal lateral cord, which is very unusual---and seems to extend into small subcutanous fibers of the lateral cord (white arrows). But there is similar nodular thickening and enhancement along the course of the long and short plantar ligament > bifurcate ligament (red arrows). What is that about? XRs looks normal except for calcaneal enthesophytes. 
Would also consider desmoid fibromatosis given the appearance.
ReplyDeleteWould that be multifocal? Would that explain what I'm seeing in the med/ctl and lateral cord plantar fascia as well as the long/short plantar and bifurcate ligaments? The referrer is a community DPM I've never heard of---would thiw warrant f/u with an orthopedic oncologist or orthopedic foot/ankle surgeon?
ReplyDeleteI agree most likely fibromatosis. Longitudinal arch is quite flat - does that alter the distribution of fibromatosis?
ReplyDeleteCalcaneocuboid joint inflammation is minor and non-specific - Does not look like a significant synovitis to me. Might relate to either mild degeneration or altered weight bearing because of flat foot and fibromatosis.
In Canada, we would not image further or follow-up.