A Case of Bilateral Baxter's Neuropathy Secondary to Plantar Fasciitis

Jaring, Matthew R.F.; Khan, Asif Z.; Livingstone, James; Chakraverty, Julian

doi:10.1053/j.jfas.2018.11.010

Cited by 7 publications

(6 citation statements)

References 5 publications

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“…The adjacent location of neural structures to the plantar fascia origin (ie, Baxter’s nerve73) could at least hypothetically provide a potential source for pain if this is aggravated, even if this is not compressed, that is, no denervation was seen on MRI for the abductor digiti minimi muscles supplied by this nerve. It is recognised that there may be cases of plantar fasciopathy which overlap with Baxter’s nerve compression74 which in this study were identified as having plantar fasciopathy and treated as such. Alternatively, it may be that the deep fascia structure that comprises the plantar fascia is in some way more susceptible to the development of neuropathic pain than the insertion of tendons into bone seen in GTPS or insertional Achilles tendinopathy, or another mechanism may be underlying this difference seen.…”

Section: Discussionmentioning

confidence: 84%

Nearly half of patients with chronic tendinopathy may have a neuropathic pain component, with significant differences seen between different tendon sites: a prospective cohort of more than 300 patients

Wheeler

2022

BMJ Open Sport Exerc Med

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ObjectivesIdentifying the prevalence of neuropathic pain components in patients with chronic tendinopathy conditions using the Self-Administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) questionnaire.MethodsPatients with chronic tendinopathy and ‘tendon-like’ conditions treated within a single hospital outpatient clinic specialising in tendinopathy were identified. Pain scores, plus global function patient-reported outcome measures (5-Level version of EuroQol-5 Dimension and Musculoskeletal Health Questionnaire (MSK-HQ)), were completed and compared with the S-LANSS questionnaireResults341 suitable patients with chronic tendinopathy and potentially similar conditions were identified. Numbers: lateral elbow tendinopathy (39), greater trochanteric pain syndrome (GTPS; 112), patellar tendinopathy (11), non-insertional Achilles tendinopathy (40), insertional Achilles tendinopathy (39), plantar fasciopathy (100). 68% were female, with a mean age of 54.0±11.3 years and a mean symptom duration of 38.1±33.7 months.There was a mean S-LANSS score of 11.4±6.4. Overall, 47% of patients scored 12 or greater points on S-LANSS, indicating the possible presence of neuropathic pain. The highest proportion was in patients with plantar fasciopathy (61%), the lowest in those with GTPS (33%). Weak correlations were found between the S-LANSS score and MSK-HQ score, the numerical rating scale (0–10) values for ‘average pain’ and for ‘worst pain’, but not with the MSK-HQ %health value.ConclusionS-LANSS identified nearly half of patients with chronic tendinopathy as possibly having a neuropathic pain component. This is of unclear clinical significance but worth further study to see if/how this may relate to treatment outcomes. These results are from a single hospital clinic dealing with patients with chronic tendinopathy, without a control group or those with shorter symptom duration. However, this reinforces the probability of neuropathic pain components in at least some patients with chronic tendinopathy.

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Section: Discussionmentioning

confidence: 84%

Nearly half of patients with chronic tendinopathy may have a neuropathic pain component, with significant differences seen between different tendon sites: a prospective cohort of more than 300 patients

Wheeler

2022

BMJ Open Sport Exerc Med

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“…Baxter's neuropathy is an uncommon cause of heel pain and can coexist with plantar fasciitis. 2,6,8 The sonoanatomy of Baxter's nerve has been well described in a recent cadaveric study. 9 Ultrasound is a valuable tool to diagnose and manage various peripheral nerve disorders.…”

Section: Discussionmentioning

confidence: 99%

“…2,4,5 Diagnosis of Baxter's neuropathy can be challenging because this condition can manifest secondary to another common heel pain syndrome like plantar fasciitis. 6 The majority of the patients respond to conservative treatment, but in recalcitrant cases, surgical release of the nerve has been found to be effective. 7,8 We describe a patient with severe heel pain that did not respond to conservative treatment, and subsequent imaging revealed features suggestive of Baxter's nerve entrapment.…”

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confidence: 99%

Ultrasound-Guided Hydrodissection for Baxter’s Neuropathy Secondary to Plantar Fasciitis: A Case Report

Sahoo¹,

Peng

Sharma

2020

A&A Practice

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Plantar heel pain is a common pain condition encountered in clinical practice. The common etiologies include plantar fasciitis, calcaneal spur, calcaneus stress fracture, systemic causes, and trauma. Neurogenic causes, including entrapment at the tarsal tunnel or Baxter's nerve entrapment, can contribute to the heel pain and should not be overlooked. In this case report, we describe a patient with severe heel pain, presenting with overlapping features of plantar fasciitis and neuropathic pain. Magnetic resonance imaging suggested Baxter's nerve entrapment, and a subsequent ultrasound-guided hydrodissection of Baxter's nerve provided long-lasting pain relief.

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“…Baxter neuropathy is a term that defines nerve entrapment syndrome resulting from the compression of the inferior calcaneal nerve (Baxter nerve), which is the first branch of the lateral plantar nerve. Since it innervates the abductor digiti minimi, imaging findings include edema-like signal intensity changes within the affected muscle and in the long term lead to fatty atrophy [48]. Figure 16 shows a case of Baxter neuropathy.…”

Section: Baxter Neuropathymentioning

confidence: 99%

Imaging Features of Plantar Vein Thrombosis: An Easily Overlooked Condition in the Differential Diagnosis of Foot Pain

Miranda,

e Castro,

Yoshimura

et al. 2024

Diagnostics

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Plantar vein thrombosis is a venous disorder affecting deep plantar veins that can manifest with non-specific localized pain, plantar foot pain, swelling, and sensation of fullness. Plantar veins are not routinely assessed during sonographic scans for deep venous thrombosis, which makes plantar venous thrombosis a commonly missed diagnosis. This paper provides a comprehensive review of the venous anatomy of the foot and imaging findings of plantar venous thrombosis as well as discusses the current literature on the topic and its differential diagnoses.

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A Case of Bilateral Baxter's Neuropathy Secondary to Plantar Fasciitis

Cited by 7 publications

References 5 publications

Nearly half of patients with chronic tendinopathy may have a neuropathic pain component, with significant differences seen between different tendon sites: a prospective cohort of more than 300 patients

Nearly half of patients with chronic tendinopathy may have a neuropathic pain component, with significant differences seen between different tendon sites: a prospective cohort of more than 300 patients

Ultrasound-Guided Hydrodissection for Baxter’s Neuropathy Secondary to Plantar Fasciitis: A Case Report

Imaging Features of Plantar Vein Thrombosis: An Easily Overlooked Condition in the Differential Diagnosis of Foot Pain

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