Bilateral precalcaneal congenital fibrolipomatous hamartomas in an eleven-week-old infant: a case report of characteristic ultrasound findings

Precalcaneal congenital fibrolipomatous hamartomas (PCFHs) are benign subcutaneous nodules of infancy, typically located on the medial plantar heel and often bilateral. We report an eleven-week-old full-term male infant with symmetrical bilateral anteromedial plantar heel nodules. Ultrasound showed well-defined, oval, hypoechoic subcutaneous nodules. The plantar fascia remained continuous, with no sonographic evidence of involvement of the underlying muscles or osseous structures. Based on the age, characteristic location, bilateral symmetry, and sonographic features, bilateral PCFH was considered the most consistent diagnosis. No biopsy or MRI was performed, and no longitudinal follow-up was available. Conservative management with parental reassurance was recommended. Recognition of this characteristic clinical and sonographic pattern may help support conservative management and avoid unnecessary invasive investigation in typical cases.