Plantar fascia (PF) disorders commonly cause heel pain and disability in the 
general population. Imaging is often required to confirm diagnosis. This review 
article aims to provide simple and systematic guidelines for imaging assessment 
of PF disease, focussing on key findings detectable on plain radiography, 
ultrasound and magnetic resonance imaging (MRI). Sonographic characteristics of 
plantar fasciitis include PF thickening, loss of fibrillar structure, 
perifascial collections, calcifications and hyperaemia on Doppler imaging. 
Thickening and signal changes in the PF as well as oedema of adjacent soft 
tissues and bone marrow can be assessed on MRI. Radiographic findings of plantar 
fasciitis include PF thickening, cortical irregularities and abnormalities in 
the fat pad located deep below the PF. Plantar fibromatosis appears as 
well-demarcated, nodular thickenings that are iso-hypoechoic on ultrasound and 
show low-signal intensity on MRI. PF tears present with partial or complete 
fibre interruption on both ultrasound and MRI. Imaging description of further PF 
disorders, including xanthoma, diabetic fascial disease, foreign-body reactions 
and plantar infections, is detailed in the main text. Ultrasound and MRI should 
be considered as first- and second-line modalities for assessment of PF 
disorders, respectively. Indirect findings of PF disease can be ruled out on 
plain radiography. Teaching Points • PF disorders commonly cause heel pain and 
disability in the general population.• Imaging is often required to confirm 
diagnosis or reveal concomitant injuries.• Ultrasound and MRI respectively 
represent the first- and second-line modalities for diagnosis.• Indirect 
findings of PF disease can be ruled out on plain radiography.