Ledderhose disease, also known as plantar fibromatosis, is a benign fibroproliferative disorder of the plantar fascia, characterized by nodular thickening and fibrosis. It is considered the plantar equivalent of Dupuytren’s contracture of the hand and part of the spectrum of superficial fibromatoses, including Peyronie’s disease.
| Feature | Description |
|---|---|
| Origin | Proliferation of myofibroblasts within the plantar aponeurosis |
| Histology | Dense collagen bundles with spindle cells (similar to Dupuytren's) |
| Disease course | Slow-growing, initially asymptomatic; may become painful and deforming |
| Feature | Description |
|---|---|
| Age group | 30–60 years |
| Sex predilection | More common in males |
| Laterality | Often bilateral |
| Associations | • Dupuytren’s contracture |
| • Peyronie’s disease | |
| • Diabetes | |
| • Epilepsy (esp. on phenytoin) | |
| • Alcoholism | |
| • Genetic predisposition (familial fibromatoses) |
| Feature | Description |
|---|---|
| Location | Medial plantar aspect of the foot, along central band of plantar fascia |
| Nodule characteristics | Firm, non-mobile, painless or painful nodules |
| Progression | May develop contracture or limit ambulation |
| Skin changes | Usually absent; no ulceration |
Dupuytren’s and Ledderhose disease. Photographs: (top panel) right hand, left hand, and left foot of the aunt (III-4), (bottom panel, left-middle) right hand and feet of the proband (IV-2) and (bottom panel, right) left foot of the sister (IV-3) with skin tethering/puckering or dimpling (white arrows), cord formation (yellow arrows), and central medial plantar nodules (black arrows). An image from one additional family member (Patient 3) was removed after consent to publish was declined.
Zaragoza MV, Nguyen CHH, Widyastuti HP, McCarthy LA, Grosberg A. Dupuytren’s and Ledderhose Diseases in a Family with LMNA-Related Cardiomyopathy and a Novel Variant in the ASTE1 Gene. Cells. 2017; 6(4):40. https://doi.org/10.3390/cells6040040
| Modality | Imaging features |
|---|---|
| US | • Location: Superficial to flexor digitorum brevis, along plantar fascia |
| • Echotexture: Hypoechoic to isoechoic nodules within fascia | |
| • Margins: Poorly defined or lobulated | |
| • Vascularity (Doppler): Minimal to absent flow; occasionally increased in active phase | |
| MR | MRI helps differentiate Ledderhose from plantar fibroma, sarcoma, or inflammatory masses |
| • T1: Iso- to hypointense relative to muscle | |
| • T2: Hyperintense (early/active) or hypointense (chronic/fibrotic) | |
| • Post-contrast: Mild to moderate enhancement (especially in cellular/active lesions) | |
| • Distribution: Fusiform nodules embedded in the plantar fascia |
![Non-contrast-enhanced magnetic resonance (MR) imaging showing two sub-centimetre nodules (arrows of a–c) along the inner band of the plantar fascia, on the left foot: (a) sagittal T1-W, (b) axial T2-W fat saturation and (c) sagittal proton density-weighted fat saturation MR images of the left foot. Source: Reprinted from Teo, F.; Mohamed Shah, M.T.; Wong. Clinics in diagnostic imaging. Singapore Med. J. 2019 [37] (Singapore Med. J. licensed under CC BY-NC-SA 4.0, no permission required).
Tomac A, Ion AP, Opriș DR, Arbănași EM, Ciucanu CC, Bandici BC, Coșarcă CM, Covalcic DC, Mureșan AV. Ledderhose’s Disease: An Up-to-Date Review of a Rare Non-Malignant Disorder. Clinics and Practice. 2023; 13(5):1182-1195. https://doi.org/10.3390/clinpract13050106](attachment:573ef7d0-4248-48a6-9f59-1ceb53f30eb5:clinpract-13-00106-g003.png)
Non-contrast-enhanced magnetic resonance (MR) imaging showing two sub-centimetre nodules (arrows of a–c) along the inner band of the plantar fascia, on the left foot: (a) sagittal T1-W, (b) axial T2-W fat saturation and (c) sagittal proton density-weighted fat saturation MR images of the left foot. Source: Reprinted from Teo, F.; Mohamed Shah, M.T.; Wong. Clinics in diagnostic imaging. Singapore Med. J. 2019 [37] (Singapore Med. J. licensed under CC BY-NC-SA 4.0, no permission required).
Tomac A, Ion AP, Opriș DR, Arbănași EM, Ciucanu CC, Bandici BC, Coșarcă CM, Covalcic DC, Mureșan AV. Ledderhose’s Disease: An Up-to-Date Review of a Rare Non-Malignant Disorder. Clinics and Practice. 2023; 13(5):1182-1195. https://doi.org/10.3390/clinpract13050106
| Condition | Distinguishing Feature |
|---|---|
| Plantar fibroma | Often considered synonymous; some reserve "fibroma" for single, well-circumscribed lesion |
| Tenosynovial giant cell tumor | More vascular; affects tendon sheath, not fascia |
| Nodular fasciitis | Rapid growth, inflammatory appearance, often upper limb |
| Sarcoma | Aggressive, heterogeneous, enhances significantly |
| Gouty tophus | Associated with hyperuricemia, variable calcification |