Plantar fasciitis and calcaneal spur formation are associated with abductor digiti minimi atrophy on MRI of the foot.
OBJECTIVE
To determine the association of atrophy of the abductor digiti minimi muscle (ADMA), an MRI manifestation of chronic compression of the inferior calcaneal nerve suggesting the clinical diagnosis of Baxter's neuropathy, with MRI markers of potential etiologies, including calcaneal spur formation, plantar fasciitis, calcaneal edema, Achilles tendinosis and posterior tibial tendon dysfunction (PTTD).


METHODS
Prevalence of calcaneal spur formation, plantar fasciitis, calcaneal edema, Achilles tendinosis and PTTD was assessed retrospectively on 100 MRI studies with ADMA and 100 MRI studies without ADMA. Patients ranged in age from 10-92 years. Pearson chi-square analyses and Fisher's exact test were used to compare prevalence of the above findings in patients with and without ADMA. Logistic regression was used to determine which variables were significantly associated with ADMA.


RESULTS
Among patients with ADMA, there was significantly greater age (57.2 years vs 40.8 years, p<0.001), presence of Achilles tendinosis (22.0% vs 3.0%, P<0.001), calcaneal edema (15.0% vs 3.0%, P=0.005), calcaneal spur (48.0% vs 7.0%, P<0.001), plantar fasciitis (52.5% vs 11.0%, P<0.001), and PTTD (32.0% vs 11.0%, P<0.001). After multivariate logistic regression analysis, only age [odds ratio (OR) 1.06, 95% confidence interval (CI) 1.03, 1.09], calcaneal spur (OR 3.60, 95% CI 1.28, 10.17), and plantar fasciitis (OR 3.35, 95% CI 1.31, 8.56) remained significant.


CONCLUSIONS
Advancing age, calcaneal spur, and plantar fasciitis are significantly associated with ADMA. Their high odds ratios support the notion of a possible etiologic role for calcaneal spur and plantar fasciitis in the progression to Baxter's neuropathy.
Chundru
Usha
U
Department of Radiology, Maimonides Medical Center, Brooklyn, NY 11219, USA. ushachundru@yahoo.com
Liebeskind
Amy
A
Seidelmann
Frank
F
Fogel
Joshua
J
Franklin
Peter
P
Beltran
Javier
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D036981:Fasciitis, Plantar / Q000209:etiology / Q000473:pathology*; D005260:Female; D036982:Heel Spur / Q000209:etiology / Q000473:pathology*; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology*; D009133:Muscular Atrophy / Q000150:complications* / Q000473:pathology*; D012189:Retrospective Studies; D012307:Risk Factors