A SHORT OVERVIEW

The key symptoms of Plantar Fibromatosis (Ledderhose Disease) are the growing nodules and eventually cords that form within and in between the tissue layers of the plantar fascia and the skin surface on the soles of the feet. The typical affected anatomical zones are marked in the attached figure. According to several studies published in the last years most cases of Ledderhose Disease involve initially only one foot, but in the later stages of the disease more than 25 percent of cases may involve clinical signs (nodules, cords, symptoms) on both feet.

FIRST SIGNS & KEY SYMPTOMS

> subjective sensation of "tightening" of the skin of the foot, but usually no visible wrinkles

> itching, burning or stinging sensations in the surrounding area of the nodules

> pain in the foot as the nodules may grow and compresses nerve routes above and below the plantar fascia

> rarely pain in the foot and ankle joints, which may be made worse by favoring this foot (weight-bearing etc.)

In general PAIN is always to be considered as an "alarming sign" from our body which should be taken serious, if it stays for a prolonged period of time. Important: Pain at the foot (sole) can be caused by a local infection, joint disorder (arthrosis or arthritis), tendon disorder (tendinitis or inflammation of the tendon insertion zone), insufficient vascular supply (e.g. by artheriosclerosis) or nerve root entrapment or metabolic disorders (e.g. diabetic polyneuropathy).

In rare cases the foot balm and the spaces between the toes can also show some signs of the condition (especially nodules). The rear part of the foot is normally not involved. If nodules appear on the backside of the toes, the pressure from these nodules in the foot can cause pain by irritation of the nerve roots and thereby may induce the toes to contract.

DIAGNOSIS OF THE DISORDER

The correct process of diagnosing Ledderhose Disease is important for the further treatment. Clearly, an experienced and qualified physician (Orthopedic Specialist, Podiatrist etc.) is the only person who should diagnose this condition by visible, palpatory and functional examinations. However, not every nodule on the foot is a sign of THIS LD condition. Those different disorders will require different therapeutic strategies. Some conditions may be serious, and self-diagnosis can put a person at risk of improper treatment, e.g. in case of a benign or malignant soft tissue tumor such as the diagnosis of an aggressive fibromatosis (desmoid tumor). Others may be less harmful like a painful ganglion cyst, which can be operated easily.

Experienced physicians can often identify the disease based on the typical location, the size and type of nodule a person has. In some cases, physicians may order imaging, e.g. X-rays, ultrasound, CT scans or magnetic resonance imaging to help confirm the diagnosis. To my mind magnetic resonance imaging is the best method to evaluate the existence and extension of Ledderhose Disaese.

Here are three LINKS to recent publications which address the diagnostic process and describe imaging procedures:

https://www.ncbi.nlm.nih.gov/pmc/article.../orr-11-001.pdf (2019)

https://www.ncbi.nlm.nih.gov/pmc/article.../SMJ-60-230.pdf (2019)

https://www.ncbi.nlm.nih.gov/pmc/article...2015-741461.pdf (2015)

With best regards and wishing for a well qualified diagnostic process for every affected individual, Prof. Seegenschmiedt

Edited 07/06/19 02:11