A 42-year-old man with a 2-month history of intermittent episodes of right heel pain was evaluated for an acutely painful right foot. Examination showed a diffusely swollen and erythematous right foot with maximal tenderness over the medial aspect of the right calcaneus. C-reactive protein was measured at 73 mg/l (normal, 0 to 6 mg/l). Intravenous antibiotic therapy was commenced and bone scintigraphy was requested to confirm the clinical impression of septic arthritis. The two-phase bone scan findings of the feet were striking, with the various attachments of the right plantar aponeurosis being vividly seen, consistent with active inflammation. After the scintigraphic diagnosis of plantar fasciitis, antibiotics were discontinued and the patient improved with oral anti-inflammatory therapy.
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