Heel pain is 1 of the most common presentations to the foot surgeon, and its causes are multifactorial. Baxter's neuropathy is caused by an impingement of the inferior calcaneal nerve and has been reported to be responsible for up to 20% of heel pain. The diagnostic imaging features are striking, with inflammation or atrophy of the abductor digiti minimi muscle. Multiple studies have found that the prevalence of this finding is much greater than initially thought. However, it is more unusual to find bilateral and symmetrical features. The possible causes of this condition lie along the course of the inferior calcaneal nerve. Management is focused on treating the underlying condition, with conservative therapy and steroid injection as the mainstay. Refractory cases may require surgical release. We present the case of a 56-year-old female presenting with bilateral foot pain. Imaging reveals symmetrical abductor digiti minimi atrophy associated with bilateral plantar fasciitis. These appearances are well demonstrated on both magnetic resonance imaging and ultrasound.
Level of Clinical Evidence
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- Plantar fasciitis and calcaneal spur formation are associated with abductor digiti minimi atrophy on MRI of the foot.Skeletal Radiol. 2008; 37: 505-510
- Imaging of foot and ankle nerve entrapment syndromes: from well-demonstrated to unfamiliar sites.Radiographics. 2003; 23: 613-623
- Selective atrophy of the abductor digiti quinti: an MRI study.Am J Roentgenol. 2007; 189: W123-W127
- Plantar fascia: imaging diagnosis and guided treatment.Semin Musculoskelet Radiol. 2010; 14: 334-343
- Inferior heel pain.Orthopaed Trauma. 2016; 30: 18-23
Published online: April 24, 2019
Financial Disclosure: None reported.
Conflict of Interest: None reported.
© 2018 by the American College of Foot and Ankle Surgeons. All rights reserved.