ankle and foot- mortons neuroma Flashcards
What is Mortons neuroma
Compression neuropathy of digital plantar nerve (66% 3rd IMT, 30% 2nd) causing benign fibrotic thickening of nerve—rarely occur in 2 IMT spaces, but 21% bilateral
Not a true neuroma/cancer
RF- chronic repetive trauma, nerve ischemia, compression
-> high arch feet, tight shoes, heavy impact
v common, age 50-55
Presentation of Mortons neuroma
Pain in forefoot (in area) sharp/burn/shooting + cramps altered sensation (pebble in shoe) Intermittant aggravated with certain footwear
examine for other signs- hallus vaglus, swealing, scars,
gait- can they weight bear
TENDER when pressing in the space
Consider ddx if pain on MTP
Mulders click- grip neuroma between forefinger and thimb (thumb on plant on foot)- other hand sqeeze MTP= click
Ix and Mx of Mortons neuroma
for Ddx - Xray, fbc, esr, uric acid
USS and MRI can confirm diagnosis
Mx -- better shoes metatarsal pad- refuce pressure stop sports NSAIDS
3m persist- orthopedic (for steroid injections, alcohol injections or surgery (neurectomy)
