P A I G E F A B R E1 3 6 5 4 5 8 4

CASE STUDY – FIBROMATOSIS

Paige Fabre

PATIENT PRESENTATION

• __ year old male• Current heel pain• Request• X-ray and Ultrasound of plantar fascia• Clinical indication: persistant pain following fall into heel.

X-RAY IMAGESX- RAY I M AG E S W E R E P E R F O R M E D B E F O R E T H E U LT RA S O U N D

ROOM PREPARATION

The room was prepared before the patient entered with:• The head of the table slightly elevated for comfort• The pillow moved from the end of the bed to allow the

patient to option of lying with their head or their chest on the pillow to ensure comfort during the examination

• The foot end of the bed was lifted slightly to allow the patient to rest with the dorsal aspect of their foot on the edge of the bed so that it may be manipulated throughout the scan

• Protective blueys were placed on the carpet below the patient’s feet and on the bed to catch any gel run-off

• The ultrasound machine was moved to the end of the bed and a selection of high frequency transducer were connected or in close proximity.

ROOM PREPARATION

• Image here

PATIENT PREPARATION

• The patient was welcomed into the room.• Their clothing was assess for accessibility.• As the patient was wearing trousers that could be easily

lifted they were not required to change.• The patient removed their shoes and socks

• The examination was explained to the patient• The patient was aware that the scan was to be performed

by a trainee with a supervising sonographer assisting

EQUIPMENT PREPARATION

• The scan was performed on a Phillips IU22• Initially a 18mHz transducer was attempted,

however due to the thickness of the patient’s heel a 12mHz multiple frequency transducer was selected to perform the scan.

IMAGING PROTOCOL

IMAGING PROTOCOL

• Imaging protocol of a plantar fascia examination is as follows:• Transverse images of the plantar aponeurosis from calcaneal

tuberosity to the distal division.• Longitudinal images of the plantar aponeurosis from calcaneal

tuberosity to the distal division.

• Further imaging of surrounding structures is encouraged if indicated by pathology seen, radiologist request or patient information.

• Doppler may be used to assess for vascularity and imaging performed as required

US EXAMINATION

D E SC R I PT I O N H E R E

IMAGES HERE

D I F F T RA N S D U C E R

D I F F T RA N S D U C E R

US FINDINGS

ULTRASOUND FINDINGS

RADIOLOGIST REPORT

FIBROMATOSIS

FIBROMATOSIS

• Def• Eitiology• Us app• treatment

REFLECTIONWHAT COULD HAVE BEEN DONE BETTER

REFLECTION

REFERENCES