Oedema of the abductor digiti quinti muscle due to subacute denervation: report of two cases.
The clinical presentation of abductor digiti quinti (ADQ) denervation is often non-specific. The diagnosis is generally clinical and may be easily missed. This case report of two patients describes the magnetic resonance imaging (MRI) finding of unilateral oedema and fatty infiltration isolated to the ADQ. A 36-year old woman who presented with laterally located left foot pain was initially diagnosed as having plantar fasciitis. An MRI scan arranged due to the unusual site of the pain showed increased signal intensity within the ADQ muscle on T1 and T2 images indicating fatty infiltration. Short tau inversion recovery (STIR) images showed hyperintensity of the ADQ indicating oedema. The MRI scan of a 45-year old man who presented with a three month history of left heel pain revealed similar findings. These MRI appearances indicate subacute denervation, which, when involving solely the ADQ muscle suggests entrapment of the first branch of the lateral plantar nerve. Consideration of this imaging finding when examining MRI scans of patients with non-specific heel pain has the potential to facilitate diagnosis.
Institute of Orthopaedics and Musculoskeletal Science, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, HA7 4LP, United Kingdom. Electronic address: mukai.cg@mac.com.
Mukai
M
Chimutengwende-Gordon
Department of Radiology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, HA7 4LP, United Kingdom.
Paul
P
O'Donnell
Foot and Ankle Surgery Department, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, HA7 4LP, United Kingdom.
Nicholas
N
Cullen
Foot and Ankle Surgery Department, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, HA7 4LP, United Kingdom.
Dishan
D
Singh
D000328:Adult; D005260:Female; D005528:Foot / Q000294:innervation*; D005534:Foot Diseases / Q000175:diagnosis*; D006365:Heel; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000294:innervation* / Q000473:pathology; D010146:Pain / Q000209:etiology
Baxter's nerve; Inferior heel pain; Muscle denervation; Plantar fasciitis