Foot Disorders - Morton's Interdigital Neuroma

Question 1

Aetiology of Morton’s Interdigital Neuroma

Answer 1

Dysfunction of a nerve in the intermetatarsal space towards the top of the foot (usually between 3rd and 4th) - irritation relating to biomechanics.

Question 2

Clinical Features of Morton’s Interdigital Neuroma (3).

Answer 2

1. Pain at the Site (Front of the Foot).
2. Sensation of Lump in Shoe.
3. Burning Numbness, Pins and Needles in Distal Toes.

Question 3

Investigations of Morton’s Interdigital Neuroma (2).

Answer 3

1. Ultrasound.

2. MRI.

Question 4

Examination of Morton’s Interdigital Neuroma (3).

Answer 4

1. Deep Pressure (at Site) = TENDERNESS.
2. Metatarsal Squeeze Test (squeeze foot and push from below) = PAIN.
3. Mulder’s Sign (Painful Click when rubbing neuroma from above and below).

Question 5

Management of Morton’s Interdigital Neuroma (4).

Answer 5

1. Avoid High Heels, Use Insoles, Weight Loss.
2. Analgesia - NSAIDs.
3. Steroid Injections.
4. Radiofrequency Ablation or Surgical Excision of Neuroma.

Question 6

Indication for Referral.

Answer 6

If symptoms persist for more than 3 months despite footwear modifications and metatarsal pads.