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Selective Atrophy of the Abductor Digiti Quinti: An MRI Study

Michael P. Recht1, Paul Grooff1, Hakan Ilaslan1, Hannah S. Recht1, James Sferra2 and Brian G. Donley2

1 Division of Radiology, A-21, Cleveland Clinic Foundation, 9500 Euclid Ave., Cleveland, OH 44195.
2 Department of Orthopedic Surgery, Cleveland Clinic Foundation, Cleveland, OH.


Figure 1
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  		Fig. 1 —There are two potential sites of entrapment of first branch of lateral plantar nerve: first, at point where nerve changes direction at inferior margin of abductor hallucis where it is compressed between abductor hallucis and medial aspect of quadratus plantae muscles; or, second, slightly more distally where nerve passes anterior to medial calcaneal tuberosity. Plantar enthesophyte may be predisposing factor for entrapment at second potential site. m. = muscle, n. = nerve. Reprinted with the permission of the Cleveland Clinic.

 

Figure 2
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  		Fig. 2 —T1-weighted coronal image in 38-year-old man shows grade 1 atrophy of abductor digiti quinti (ADQ) muscle. Note normal muscle bulk of adjacent musculature. AH = abductor hallucis, FD = flexor digitorum brevis, QP = quadratus plantae.

 

Figure 3
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  		Fig. 3 —T1-weighted coronal image in 33-year-old woman shows increased fat within abductor digiti quinti muscle corresponding to grade 2 atrophy.

 

Figure 4
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  		Fig. 4A —52-year-old man with abductor digiti quinti (ADQ) muscle atrophy. T1-weighted coronal image shows almost complete fatty atrophy (arrows) of ADQ muscle consistent with grade 3 atrophy.

 

Figure 5
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  		Fig. 4B —52-year-old man with abductor digiti quinti (ADQ) muscle atrophy. Sagittal STIR image shows mild plantar fasciitis and plantar enthesophyte (arrow). Incidental note is made of mild edemalike signal change within talus.

 

Figure 6
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  		Fig. 5 —Fat-suppressed T2-weighted coronal image in 57-year-old woman shows grade 3 atrophy (arrows) of abductor digiti quinti muscle with no evidence of increased T2 signal within muscle.

 

Figure 7
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  		Fig. 6 —T1-weighted image in 69-year-old woman shows fatty atrophy of both abductor digiti quinti muscle (arrows) and abductor hallucis muscle (arrowheads). This patient was not included in study group.

 

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