MRI of the plantar structures of the foot after falanga torture
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.
Author: Savnik, A. | Amris, K. | Røgind, H. | Prip, K. | Danneskiold-Samsøe, B. | Bojsen-Møller, F. | Bartels, E.M | Bliddal, H. | Boesen, J. | Egund, N.
RCT Author: Karen PripRCT Author (No longer employed at RCT): Kirstine Amris
Source: European radiology ; vol. 10, no.
10
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 20ms),
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 mindre end
0.05).
In all except one of the victims, MRI demonstrated two layers of
the thickened plantar aponeurosis : a deeper portion
with normal homogenous 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
of the foot