Boney traction spurs on the origin of the plantar fascia are so common as to be almost NON-pathological. In anatomical skeletal preparations, one can find them at multiple sites of ligamentous connections across joints as an incidental finding when you is dissecting a cadaver in Freshman anatomy lab.
I have them surrounding several lumbar vertebrae, in my shoulders and around my knees but NONE specifically are a source of pain (no "point tenderness")
For example they represent old, and repeated inflammation in the connective tissue that makes up the plantar fascia and all they tell the physician, is that some time in the past, an ongoing inflammation (with secondary calcification) has occurred there. Removal of them in response to a diagnosis of plantar fasciitis would be akin to removing a lung for pneumonia. Radical and in the long term, not curative.
Traction spurs can occur at many places and usually have similar etiologies.
https://www.mayoclinic.org/diseases-...s/syc-20370212
This report's non-specific use of the term "lesion" could be most anything but I interpreted it as "stress fracture:" an internal break that has not gone through to the periosteum (a surface covering the boney surface where most of the vascularization to the bone originates)...
Early on (much like a small crack in a windshield) these are almost asymptomatic, and they can only be found on standard X-ray when they begin to heal and show a more dense surface above them (bone callus)..usually 2 to 3 weeks post trauma. They may, or may not be symptomatic enough to be painful as often when I asked patients to explain to me what level of discomfort the had on a 1 to 10 scale, they would usually respond on the lower end of that scale.
I treated a member of the Vancouver professional soccer team (the White Caps), advised him to rest until it healed, but he went ahead and played in the final championship game and it fractured full thickness.
To adequately diagnose them you have to resort to Computerized Axial Tomography (a tomogram looks through tissue in progressive thin layers of the tissues so it can visualize a lesion that has not reached the surface of the bone), scintography which uses radioactive uptake at areas of higher molecular activity (such as occurs in early bone healing). The most common radiopharmaceutical for bone scintigraphy is 99mTc with methylene diphosphonate (MDP). MDP adsorbs onto the crystalline hydroxyapatite mineral of bone.
Finally an MRI that not only allows thin anatomical sections to be accessed progressively through the full thickness of the bone, BUT also differentiates tissue types, i.e. cartilage, new bone callus, connective tissue, blood vessels etc. Most specific but most expensive as well....
