Compressive neuropathy of the first branch of the lateral plantar nerve: a study by magnetic resonance imaging

Abstract

ObjectiveTo assess the prevalence of isolated findings of abnormalities leading to entrapment of the lateral plantar nerve and respective branches in patients complaining of chronic heel pain, whose magnetic resonance imaging exams have showed complete selective fatty atrophy of the abductor digiti quinti muscle.Materials and MethodsRetrospective, analytical, and cross-sectional study. The authors selected magnetic resonance imaging of hindfoot of 90 patients with grade IV abductor digiti quinti muscle atrophy according to Goutallier and Bernageau classification. Patients presenting with minor degrees of fatty muscle degeneration (below grade IV) and those who had been operated on for nerve decompression were excluded.ResultsA female prevalence (78.8%) was observed, and a strong correlation was found between fatty muscle atrophy and plantar fasciitis in 21.2%, and ankle varices, in 16.8% of the patients.ConclusionFatty atrophy of the abductor digiti quinti muscle is strongly associated with neuropathic alterations of the first branch of the lateral plantar nerve. The present study showed a significant association between plantar fasciitis and ankle varices with grade IV atrophy of the abductor digiti quinti muscle.

Psychosocial variables and presence, severity and prognosis of plantar heel pain: A systematic review of cross‐sectional and prognostic associations

“…Plantar heel pain (PHP) is an umbrella term for pain on the plantar aspect of the heel (Riel et al, ). The terminology associated with PHP is varied, including plantar fasciitis, plantar fasciopathy and chronic plantar heel pain, which reflects the limited understanding of the pathoaetiology of this disorder, with suggested inflammatory, degenerative, vascular and neural components (McMillan, Landorf, Barrett, Menz, & Bird, ; Rodrigues et al, ). Adult foot complaints are common; an Australian survey reported a 17.5% prevalence of foot pain in the general population, with approximately 20% of these respondents reporting heel pain (Hill, Gill, Menz, & Taylor, ).…”

Clinics in diagnostic imaging (205)

“…(3) Two possible sites of nerve entrapment have been described. (4)(5)(6) The first site is where the nerve crosses the deep fascia of the abductor hallucis between the abductor hallucis and medial caudal margin of the quadratus plantae; contributory factors include altered biomechanics such as pes cavus or excessive pronation as well as muscle hypertrophy. The second is where the nerve passes just anterior to the medial calcaneal tuberosity.…”

Der neuropathische Fußschmerz und seine Differenzialdiagnosen

“…Der R. muscularis zum M. abductor digiti V, genannt Baxter-Nerv (nach dem amerikanischem Arzt Donald Baxter), ist der erste Abgangsast des N. plantaris lateralis am Tarsaltunneleingang und leitet motorische und sensible Fasern bis zur kleinen Zehe (44)(45)(46)(47). Er zieht an der inneren Seite der Ferse in die Tiefe, kreuzt die Fascie des M. abductor hallucis und gelangt zum Ansatz der Plantaraponeurose am Fersenbein.…”