MRI of the plantar structures of the foot after falanga torture |
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Authors: | A Savnik K Amris H Røgind K Prip B Danneskiold-Samsøe F Bojsen-Møller E M Bartels H Bliddal J Boesen N Egund |
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Institution: | Department of Radiology, Frederiksberg Hospital, Denmark. |
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Abstract: | Falanga is an ancient form of punishment or torture but is still commonly reported by our refugees. The late result of caning
the heel and ball of the foot is a chronic painful condition with few clinical signs. The aim of the present study was to
assess, by MRI, possible morphologic characteristics of the heel and ball of the foot, related to falanga and pain in correlation
to clinical findings. Magnetic resonance imaging of the foot was obtained in 12 victims exposed to falanga torture and 9 healthy
volunteers. Sagittal T1-weighted spin-echo images (TR 616–840 ms, TE 20 ms), T2-weighted spin-echo images (TR 1900 ms, TE
90 ms), and short tau inversion recovery (STIR) images (TR 1200 ms, TE 15 ms, TI 100 ms) were performed. The central portion
of the plantar aponeurosis was generally significantly thicker in victims exposed to falanga torture as compared with that
of controls (P < 0.05). In all except one of the victims, MRI demonstrated two layers of the thickened plantar aponeurosis: a deeper portion
with normal homogeneous low signal intensity (SI) appearance, and a superficial layer with characteristic areas of mixed SI
on both T1- and T2-weighted images. There were no signs of chronic muscular compartment syndromes, and the thickness of the
plantar pad did not differ between the two groups. Magnetic resonance imaging may demonstrate morphologic characteristics
of the plantar aponeurosis which may confirm falanga torture. Further imaging with more specific sequences is warranted to
demonstrate the supposed injuries in the compartmental fat tissue chambers and the vascularity of the ball pad of the foot.
Received: 25 November 1999; Revised: 8 February 2000; Accepted: 6 April 2000 |
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Keywords: | : Foot – Aponeurosis – MRI – Fasciitis – Torture |
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