Although edema about the plantar fascia insertion may be seen on magnetic resonance imaging and ultrasound, plantar fasciitis is diagnosed clinically. About 70% of patients with this condition also have radiographic evidence for heel spurs (9). However, heel spurs can also be found in asymptomatic patients and recent studies suggest that the bone spurs are more often associated with the flexor digitorum brevis than the plantar fascia. Bone scans are helpful in identifying stress reactions or fractures. Laboratory studies may be useful in elucidating rheumatologic causes of heel pain. However, HLA-B27 has only 65% sensitivity for ankylosing spondylitis and rheumatoid factor has only 50% specificity.
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