Morton's neuroma; Morton's entrapment; intergidital or intermetatarsal neuroma

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Etiology

Epidemiology

  • uncommon
  • women affected 4-fold more often than men[3]

Pathology

Clinical manifestations

  • burning pain at the 2nd or 3rd web space between the toes
  • pain may radiate to the tips of the involved toes
  • unilateral in most cases
  • most commonly in the web space between the 3rd & 4th toes but may be found in the 2nd web space
  • tenderness to palpation at the involved webspace
  • symptoms reproduced by compression of the involved metatarsals
  • weight-bearing exacerbates symptoms
    • runners may feel pain as they push off from the starting block
  • removal of shoes may relieve symptoms
  • generally, not palpable
  • pain may be described as cramping[3] or walking on pebbles[1]

Radiology

Differential diagnosis

Management

More general terms

Additional terms

References

  1. 1.0 1.1 Medical Knowledge Self Assessment Program (MKSAP) 11, 16, 18. American College of Physicians, Philadelphia 1998, 2012, 2018.
  2. UCLA Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001
  3. 3.0 3.1 3.2 Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004
    Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013
  4. Wu KK. Morton neuroma and metatarsalgia. Curr Opin Rheumatol. 2000 Mar;12(2):131-42. PMID: https://www.ncbi.nlm.nih.gov/pubmed/10751016
  5. 5.0 5.1 Thomson CE et al. Methylprednisolone injections for the treatment of Morton neuroma: A patient-blinded randomized trial. J Bone Joint Surg Am 2013 May 1; 95:790. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23636185 <Internet> http://jbjs.org/article.aspx?articleid=1679101
  6. Adams WR 2nd. Morton's neuroma. Clin Podiatr Med Surg. 2010 Oct;27(4):535-45 PMID: https://www.ncbi.nlm.nih.gov/pubmed/20934103
  7. Thomson CE, Gibson JN, Martin D. Interventions for the treatment of Morton's neuroma. Cochrane Database Syst Rev. 2004;(3):CD003118. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15266472
  8. 8.0 8.1 8.2 Barrett SL, Woolley M Managing Morton's Entrapment Practical Pain Management. Sept 2, 2011 http://www.practicalpainmanagement.com/pain/other/managing-morton-entrapment
  9. Morton's Neuroma American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org/topic.cfm?topic=A00158