Communication Affichée: Poster tour 2

Le 14/10/2021 de 17:30 à 18:00

Retour Session


Importance de l'examen clinique: une aponévrosite plantaire atypique chez un triathlète. Cas clinique

Jérémie Bordes (Limoges, France), Julie Péroua-Viault (Périgueux, France), Jacques Monteil (Limoges, France)

Objective : A 38 year old regional triathlete had been suffering from pain in the plantar surface of his left foot for 3 years, which had handicapped him in his running training.

Material / Patients and Methods : After an MRI, CT scan and ultrasound, the diagnosis of plantar fasciitis was made.

The following therapies were carried out without efficacy:

- Eccentric stretching according to the Stanish protocol.

- Shock waves

- Deep transverse friction massages

- osteopathy sessions

in persistent pain despite 6 months of physiotherapy, a Bone scintigraphy was performed and eliminated overuse fracture

Results : Upon resuming the clinical examination, an infracentimetric plantar nodule was found at the inspection, which was painful on palpation. Upon questioning, the patient finally remembered having stepped on an acacia thorn three years earlier, a thorn that had pierced the soles of his shoes.

A new ultrasound was performed and found a hyperechoic linear image 5mm long in the plantar fascia and in contact with the V abductor. This image was in favor of a foreign body. Taking the elements from his file, the foreign body was already visible on the scanner performed two years earlier.

The patient was operated on one month later by an orthopedic surgeon. The removed spine was 5mm long. After the operation, the athlete presented no pain and was able to resume running at his previous level.

Discussion - Conclusion : This case report demonstrates once again the importance of the clinical examination to the detriment of complementary examinations. Interrogation, inspection, palpation, auscultation and percussion are still in 2021 the essential elements for a good diagnostic approach.

Keywords : aponévrosite plantaire corps étranger

Disclosure of interest : non