Yury Gorety Medina Rojas, n/a
Physical Medicine and Rehabilitation Resident
Departamento de Medicina Física y Rehabilitación, Facultad de Medicina, Universidad Nacional de Colombia
BOGOTA, Distrito Capital de Bogota, Colombia
Liliana Elizabeth Rodriguez Zambrano, MD
Physiatrist
Universidad Nacional de Colombia - Hospital Universitario Nacional
bogota, Cundinamarca, Colombia
Jorge Arturo A. Diaz Ruiz, N/A, MD
Physical medicine And rehabilitation physician
Universidad Nacional de Colombia- Centro de Investigacion en Fisiatria y Electrodiagnostico - CIFEL
bogota, Cundinamarca, Colombia
Jorge Nicolas Muñoz Rodriguez, MD
Physical medicine And rehabilitation physician
Universidad Nacional de Colombia. CIFEL - Centro de Investigación en fisiatría y Electrodiagnóstico
Bogota, Distrito Capital de Bogota, Colombia
Injury to Baxter's nerve is infrequent and represents 15-20% of chronic heel pain cases. Although it is a common and disabling condition, its diagnosis is complicated due to different etiologies with similar clinical presentations, such as plantar fasciitis. Therefore, this pathology is often underdiagnosed and wrongly treated.
Case Description:
A 32 years old male patient, with no medical history.He plays soccer and Jiu-Jitsu. He presents 6month clinical history of burning pain diffusing toward the medial aspect of the heel and posterior paresthesia and an increase in areas of higher pressure.
On physical examination, he presents sensitivity of the skin and pain on the midlateral side, gait is limited. The electrodiagnostic studies with nerve convention tests did not evaluate specific branches of these areas, MRI of the foot and electrodiagnostic studies showed no abnormalities. After persistent symptoms, he returned for further evaluation. it was considered to perform additional electrodiagnostic tests on the calcaneal branch of the tibial nerve. These studies showed absence of response of affected nerve. Neuromuscular ultrasonography was performed, revealing a hypoechoic structure on the side of the nerve baxter left.he was referred to the orthopedic service, he had surgical procedure and physical rehabilitation, resulting in clinical improvement.
Discussions:
Baxter’s nerve injury is an underdiagnosed cause of chronic heel pain, often mistaken for other common pathologies. Diagnostic imaging support is useful for correlating clinical and electrophysiological findings, enhancing diagnostic accuracy for the patient.
Conclusions:
The Baxter's cyst is an infrequent cause of heel pain. These disease processes may occur together and may be difficult to distinguish. However, treatment strategies to them are different, which makes establishing an accurate diagnosis crucial in the management of these patients.
The of electrodiagnostic studies and ultrasonographies are important for preventing chronic pain and it improving patient's clinical outcomes, generating impact on quality of life.
