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MORTON'S NEUROMA

Rheumatology

MORTON'S NEUROMA

1. The most common location is B/W the third and fourth metatarsal heads, leading to referral of pain and paresthesia down the two toes.

2. Patients sometimes describe a sensation of having a pebble in their shoe or a wrinkle in their sock.

3. Pain is exacerbated with forefoot weight-bearing, narrow toe boxes, and high heels, all of which can load the pathologic region.

4. DDx - metatarsalgia.

5. Occasionally there's a click when palpating, especially when combined with squeezing the metatarsal heads together.

6. First-line interventions aim to unload the forefoot, local steroid injection, surgical excision for recalcitrant neuromas.


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REFERENCES

1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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