Disclosures: Jasmine H. Harris, MD: Nothing to disclose

Case Description: A patient diagnosed with plantar fasciitis with worsening right ankle and foot pain despite several sessions of physical therapy was referred to outpatient rehabilitation clinic. The patient described pain as sharp and “shooting” from the anterolateral ankle and radiating to the dorsum of the foot and occasionally to plantar aspect. Physical exam was significant for findings which did not correlate with a simple case of foot plantar fasciitis- in addition to tenderness with palpation to lateral ankle, there were sensory impairments in the right dorsum and plantar foot and weakness of the foot and toes. An EMG study was ordered to rule out tarsal tunnel syndrome versus peripheral neuropathy versus lumbosacral radiculopathy.

Setting: Outpatient Rehabilitation Clinic

Patient: A 60-year-old man with history of type 2 diabetes mellitus and recent diagnosis of right plantar fasciitis.

Assessment/Results: EMG showed no response of right lateral plantar nerve, prolonged distal latency to right abductor digiti quiti pedis (ADQP), and giant MUAPs in right abductor digiti minimi quinti pedis (ADMQP). These findings were suggestive of compression of the right inferior calcaneal nerve.

Discussion: Plantar foot pain symptoms are commonly attributed to plantar fasciitis. Another less common cause of foot pain may be due to compression of the inferior calcaneal nerve (ICN), also known as Baxter’s neuropathy. Physical therapy treatment for presumed plantar fasciitis can be ineffective and potentially worsen symptoms of Baxter’s neuropathy.

Conclusion: Electrodiagnostic evaluation is helpful in diagnosis of Baxter’s neuropathy. It is prudent to consider alternative diagnoses of foot pain to initiate appropriate rehabilitative therapy and symptom management.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/a-presumed-plantar-fasciitis-found-to-be-baxters-neuropathy-on-emg-a-case-report/