Fact-sheet: Fibromatose superficielle


Updated on 02/22/2024 at 1:40 PM

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Definition

Synonym: Ledderhose disease.

Belongs to the superficial fibromatoses (such as Dupuytren disease and Peyronie disease, with which it may be associated).

Benign proliferation of fibroblasts: thickening of the plantar fascia.

Clinical features

Patients aged 30 to 50 years.

Nodular thickening at the base of the metatarsals, involving the superficial aspect of the plantar fascia.

  • One or more nodules
  • Bilateral in 20 to 50% of cases
  • Pain uncommon
  • No tendon retraction (unlike Dupuytren disease)

Ultrasound

Heterogeneous hypoechoic nodule:

  • From a few mm to 2 cm
  • Sagittal long axis
  • +/- Doppler hyperemia

MRI

Nodule (1 mm to 2 cm) on the superficial aspect of the plantar fascia

  • T1: hypointense or isointense
  • T2: variable
  • possible heterogeneous enhancement after gadolinium injection

Sparing of the deep fascial layer (unlike sarcoma).
N.B.: in the late phase, the deep layer may be involved.

Most often opposite the base of the metatarsals: unlike fascial rupture or plantar fasciitis.

Multiple nodules and/or contralateral involvement: favors the diagnosis

Management

Surgery possible if painful.
Frequent recurrence.

Differential diagnosis

  • Sarcoma: involvement of the deep layer of the plantar fascia
  • Plantar fasciitis: more proximal region
  • Fascial rupture: more proximal region

Sources:

  • Oncle Paul
  • Imagerie musculo-squelettique : pathologies loco-régionales, A. COTTEN (ISBN 9782294721823)