Calcaneal Osteomyelitis - A Rare Complication of Steroid Injection for Plantar Fascitis - A Case Report

Abstract

Plantar fasciitis is commonly treated with corticosteroid injections to decrease pain and inflammation. Therapeutic benefits often vary in terms of efficacy and duration. Rupture of the plantar fascia has been reported as a possible complication following corticosteroid injection, but we present a rare complication of Osteomyelitis of calcaneum following corticosteroid injection.  

A 41-year-old female patient presented with complaints of back ache and difficulty in walking with no history of any previous trauma. Detailed history revealed that she had taken steroid injection for heel pain. Examination revealed bluish discoloration and swelling just below the medial malleolus and around the heel with local rise of temperature and severe restriction of range of movement of left ankle. MRI investigation revealed osteomyelitis of posterior third calcaneum with abscess inferior to calcaneum involving plantar muscles. Patient underwent surgical debridement for the same.

Steroid therapy is a valuable adjunct to other therapy measures, including plantar fascial stretching. However, one should be cognizant that overuse of steroid injection can lead to severe complications. Steroid injections should be performed with ultrasound monitoring to reduce complications.