What is Mortons neuroma?
Mortons neuroma is caused by entrapment of the interdigital plantar nerve most commonly by the transverse metatarsal ligament, usually located between the third and fourth or second and third metatarsal heads.
This occurs more commonly in women who wear tight-fitting shoes or high heels. Patients complain of dysesthesias between the two toes and state that they feel like they are walking on a marble or wrinkled sock.
Metatarsal compression may cause a palpable click (Mulder click) as the neuroma is forced downward, where it may be felt on the plantar surface. Ultrasound and MRI can confirm the diagnosis. Treatment consists of wearing more supportive shoes, padding the metatarsal heads, and local steroid injections. Surgical removal is done if conservative therapy fails.
Where does Mortons neuroma occur?
A Morton’s neuroma is an abnormality of the plantar digital nerve, which is located between the metatarsal heads, toward the plantar surface of the foot.
A Morton’s neuroma is not a true neoplasm, but rather represents focal perineural fibrosis, which is often a result of ill-fitting shoes.
There is a marked female preponderance, and it typically occurs in the second or third intermetatarsal spaces. Although the enhancement pattern is variable, intense enhancement is common.
Morton’s neuromas are often associated with inflammation of the bursa between the metatarsal heads, referred to as intermetatarsal bursitis.