Morton Neuroma

[Diane]

Hi Stephen,

Can I convince you of the attached videos and pictures that this is a morton’s neuroma. I’m always a bit in awe when I actually do see one because I scan so many that query it and I see nothing.

Do you have any more cases with morton’s neuromas? Are they always quite obvious or is there subtle signs that we have to look out for? I also have trouble identifying the interdigital nerve sometimes, any tips?

Thanks!

Attachments:

You must be logged in to view attached files.

[Stephen Bird]

Hi Diane,

To be honest I am not that impressed that there is much of a neuroma here.
I do like your technique, the foot you are scanning is very thin so you are getting a great look.
In the videos you are in the perfect spot with your transducer right between the plantar plates in the long axis with a plantar approach. Your use of a finger from the dorsal aspect is also perfect .
What you are seeing is a small intermetatarsal bursa which is compressing when you push with your finger and the transducer. When you achieve compression you have a nerve that is slightly thickened so I think there is a degree of perineurial fibrosis, but the amount is small. So in essence I think it is a “Mortons neuroma” but a small one and I question how symptomatic it would be at this size.

I will find some more examples of neuromas and load them onto this discussion thread for you.

If you watch the metatarsalgia webinar you will see some examples as well.

Steve

[Author]

Posts