Unexpected sequelae of plantar fasciitis: latrogenic calcaneal osteomyelitis following plantar heel injection
- Author:
Sharina bt. Mohd Khalid
;
Mohd Yazid Bajuri
- Publication Type:Case Reports
- Keywords:
aseptic;
calcaneus;
corticosteroid;
plantar fasciitis;
osteomyelitis
- From:Malaysian Family Physician
2019;14(3):80-83
- CountryMalaysia
- Language:English
-
Abstract:
The injection of a local anesthetic in combination with a corticosteroid is an accepted choice in
the treatment of plantar fasciitis with recalcitrant heel pain. When the injection is performed
properly, post-injection infection is extremely rare. We are reporting a rare case of chronic calcaneal
osteomyelitis that developed secondary to a local corticosteroid injection. A 56-year-old lady
diagnosed with right plantar fasciitis presented with a 6-month history of pain and a persistent
sinus with serous discharge of her right heel following a local infiltration of a corticosteroid. A
Magnetic Resonance Imaging demonstrated right calcaneal osteomyelitis with intramuscular
abscess. Surgical drainage and debridement were done, followed by antibiotic therapy. A recurrence
of infection was not detected throughout the duration of follow-up. It is suggested that a plantar
heel injection be done in a more controlled environment, such as in operating theatre, to reduce
the risk of infection and to avoid injecting a steroid as compared to platelet-rich plasma (PRP) in
view of their safety profiles. However, such an injection should only be offered after conservative
treatment has failed, as 80% of patients recover well after initial conservative management.
- Full text:2.2019my0058.pdf
