Why Do My Heels Look Almost Transparent and have so many tiny cracks On X-Ray? The tops of my toe bones, too.

by wrecmom
(Arkansas, U. S. A.)

I have significant scoliosis, osteoarthritis, and my feet hurt very badly on the heels, tops of feet, and sometimes it feels like the muscle tears in my arch, mainly on the right side, which is my longer leg by about an inch. Also,my Tibia and/or fibula Hurt in a bracelet fashion near the bottom on the left leg. Left shin had pitting edema for about ten years, which has improved dramatically with weight loss of 50 lbs. It feels as if the bones are suddenly cracked at times, (near bottom of Tibia and Fibula)then the pain goes away just as quickly as it came. I have included spinal x-ray as it might be helpful. ? It really hurts even to lay flat in bed and have heels touching the matress, and foot pain is never relieved by sleep or rest. I do think I have heel spurs, according to Google images, and I see a funny protrusion on the right where the ankles meet the shinbones. My doctors won't go into specifics with me about things. Only Google explains stuff. :)

ANSWER

Hi,

It appears as if you have a very, very small heel spur on the right foot. Is this of any significance? Not really. If you have plantar fasciitis this may represent a slight worsening of the condition as the heel spur represents calcification of the plantar fascial ligament, but I will also tell you that I routinely see heel spurs as incidental findings on people who we x-ray for unrelated foot issues.
Years ago we used to make a distinction between plantar fasciitis and heel spurs but as medicine as progressed there is less importance, particularly in very small spurs such as yours.
I do not know how old you are but based on your foot x-rays I am guessing you are not very old for the simple reason I see virtually no arthritic degeneration of the joints in your feet and on the basis of only your foot x-rays I would say you have no osteoarthritis. You have nice even spaces between almost all your joints on both feet.
The transparency in your foot x-rays may just be a result of the settings used when the x-rays were taken or may be indicative of osteoporosis. Have you had a bone density exam.
If it turns out that you are osteoporotic that would go a long way in accounting for your foot pain. osteoporosis is one of those conditions that can give you very achy feet simply because of lack of good bone stock to support your weight.
I also think it is safe to say that your scoliosis is also part of the problem with your foot pain, as it creates a limb length discrepancy which would alter your gait and thus cause foot pain.
I would recommend you find a good foot specialist who will take the time to explain things to you. To solve your foot aches and pains is probably going to require some sort of orthotic to create better foot and leg balance. It will probably take a little trial and error, so it is important you find someone you can work with and will explain things to you.

Marc Mitnick DPM
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