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Baxter’s nerve impingement

Case contributed by Dr Martin Perez Romagnoli

Presentation

Heel pain. Flat foot valgus and pain in the tarsal sinus.

Patient Data

Age: 50 years
Gender: Female

MRI

MRI

MRI images show fatty atrophy of the abductor digiti minimi muscle and disruption of plantar fascial fibers, suggestive of Baxter’s nerve impingement.

Case Discussion

Heel pain is a common presenting complaint to the foot and ankle specialist, with a wide differential diagnosis including plantar fasciitis, fat pad atrophy, calcaneal stress fracture or apophysitis, inflammatory arthropathy, neoplasia, and infection. One of the more elusive diagnostic considerations in heel pain is entrapment of first branch of the lateral plantar nerve (Baxter’s nerve impingement).

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