OCAD MSK

History

Refractory heel pain

Figure 1 for case Baxters Neuropathy — Figure 1

Figure 2 for case Baxters Neuropathy — Figure 2

Figure 3 for case Baxters Neuropathy — Figure 3

Figure 4 for case Baxters Neuropathy — Figure 4

Discussion

There is severe, chronic fatty atrophy of the abductor digiti minimi (arrow) as a result of compression of the 1st branch of the lateral plantar nerve (aka Baxters nerve) as it courses between the plantar calcaneus and the FDB (see slide 4, illustrating 2 potential sites of impingement). Plantar calcaneal enthesophytes and thickening of the plantar fascia may more commonly compress the nerve. Symptoms can mimic those of plantar fasciitis and Baxters neuropathy should be considered in cases of refractory plantar fasciitis. Make a point of commenting on the ADM muscle in hindfoot/ankle MRI for evaluation of heel pain.

Diagnosis

Baxters Neuropathy

Hilary Umans, MD

Courtesy

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