Mortons Neuroma

Question 1

What is Mortons Neuroma?

Answer 1

⇒ Is a benign growth of nerve tissue that typically occurs at the level of the intermetatarsal ligament, most often between the 3rd & 4th metatarsal bones

Question 2

Is this common?

Answer 2

Yes

Question 3

Why is it common in females?

Answer 3

Use of high heels / narrow shoes

Question 4

What could be possible causes of MN?

Answer 4

Irritation, pressure or injury to the nerve from:
• High impact sporting activities – e.g running, karate, court sports.
• High-heeled shoes
• Trauma/injury
• High arches (cavo varus) – these patients are much more likely to suffer from Morton’s neuroma than others.
• Flat feet

Question 5

What are some Presenting Signs & Symptoms of MN?

Answer 5

• A tender, dorsally bulging tumour can occasionally be palpated in the intermetatarsal space.
• Pain in the forefoot as sharp, stabbing, burning, cramping or throbbing.
• Some describe a sensation like walking on razorblades, a poking red hot needle, also common is a sensation similar to walking with a pebble in the shoe.
• Pain is often reproduced on weight-bearing
• Paresthesia

Question 6

What tests can be used for MN?

Answer 6

o Web space compression test
Squeezing the metatarsal heads with one hand along the transverse plane, while simultaneously compressing the implicated web space with the thumb and index finger of the other hand.

Question 7

What is the Mulder’s sign?

Answer 7

A positive result in the Web space compression test - production of a painful and palpable click, called Mulder’s sign

Question 8

What is a positive Tinel’s sign?

Answer 8

Upon percussing, patient experiences a tingling sensation along the distribution of the nerve.