Plantar fibromatosis

Plantar fibromatosis is most frequently present on the medial border of the sole, near the highest point of the arch. Only 25% of patients show symptoms on both feet (bilateral involvement). The disease may also infiltrate the dermis or, very rarely, the flexor tendon sheath. ==Risk factors==

The histological and ultrastructural features of Ledderhose and Dupuytren's disease are the same, which supports the hypothesis that they have a common cause and pathogenesis. There are certain identified risk factors. The disease is more commonly associated with: • A family history of the disease • Higher incidence in males • Palmar fibromatosis 10–65% of the time. • Peyronie's disease • Epilepsy patients • Diabetes mellitus There is also a suspected, although unproven, link between incidence and alcoholism, smoking, liver diseases, thyroid problems, and stressful work involving the feet. ==Diagnosis==

A combination of physical examination of the arch and plantar fascia, as well as ultrasound imaging by a physician is the usual path to diagnosis. An MRI (Magnetic Resonance Imaging) scan is usually the imaging of choice to determine between other possible conditions such as ganglion cysts. MRI tends to be more accurate than x-ray or ultrasound, showing the full extent of the condition. ==Treatment==

Although the origin of the disease is unknown, there is speculation that it is an aggressive healing response to small tears in the plantar fascia, almost as if the fascia over-repairs itself following an injury. There is also some evidence that it might be genetic. Post-surgical radiation treatment may decrease recurrence. Collagenase injection, FDA-approved for Dupuytren's contracture with favorable outcomes, showed no benefit in a reported case of plantar fibromatosis. Cryotherapy has also been reported as an effective treatment for Ledderhose disease, with an approximate 80% success rate and potentially lower recurrence than conventional surgery. Cortisone injections, such as triamcinolone, Topical verapamil is also used to treat plantar fibromatosis. == See also ==