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Baxter neuropathy

Case contributed by Salem Bauones
Diagnosis almost certain

Presentation

Heel pain.

Patient Data

Age: 45 years
Gender: Female
ct

Coronal CT images show amyotrophy of the abductor digiti minimi muscle.
Sagittal CT images show a plantar calcaneal enthesophyte.

mri

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: 

  1. deep to or adjacent to the fascial edge of a hypertrophied abductor hallucis muscle
  2. along the medial edge of the quadratus plantae muscle
  3. 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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