Forefoot pain following steroid injection

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Dear all

I have a 29 year old female patient who is a competitive long distance runner and has been suffering from symptoms similar to plantar fasciitis for the past 8 months. The onset of the injury, however, was sudden and came on during a sprint session. She has since been treating herself by taping the injury prior to every run and it has reduced to a low grade pain. As the injury has not resolved completely she underwent diagnostic ultrasound which found an area of thickening of the plantar fascia about 2cm distal to the enthesis which was thought by the radiologist to be a healed partial rupture rather than plantar fasciitis. X-ray showed no evidence of stress fracture and MR confirmed high signal and mild effusion around the area of thickening. A steroid injection was given which seemed to ease symptoms until she tried to run when she suffered acute pain in her lesser toes resulting in her being unable to run or even walk without limping to avoid pressure on the forefoot. A week later this is still just as bad although she has not been back to the hospital. It is not possible to reproduce the pain by palpating the foot and passive extension of the toes is pain free, however she is unable to propulse through the lesser toes and any weightbearing on the forefoot causes extreme pain. Does anyone have any ideas or similar experiences following steroid injection for plantar faciitis? Many thanks.

 

I just found this thread. Since it was some time ago, how did things work out for this patient?

I think rupture of the plantar fascia is a possibility for this patient.