Baxter neuropathy
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Diagnosis almost certain
Presentation
Heel pain.
Patient Data
Age: 45 years
Gender: Female
From the case:
Baxter neuropathy
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Coronal CT images show amyotrophy of the abductor digiti minimi muscle.
Sagittal CT images show a plantar calcaneal enthesophyte.
From the case:
Baxter neuropathy
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Multiplanar MRI images demonstrate the following :
- fatty atrophy of abductor digiti minimi muscle.
- plantar calcaneal enthesophyte and plantar fasciitis as causative pathologies.
Case Discussion
Baxter neuropathy is a nerve entrapment syndrome resulting from the compression of the inferior calcaneal nerve.
The inferior calcaneal nerve is the first branch of the lateral plantar nerve which courses in a medial to lateral direction between the abductor hallucis muscle and the medial calcaneal tuberosity.
There are three sites of possible entrapment:
- deep to or adjacent to the fascial edge of a hypertrophied abductor hallucis muscle
- along the medial edge of the quadratus plantae muscle
- adjacent to the medial calcaneal tuberosity
Flatfoot, calcaneal enthesophyte, plantar fasciitis, fat pad disorders and seronegative spondyloarthropathies are considered as causative pathologies.
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