II. Definition

  1. Perineural fibrosis of plantar nerve
  2. Affects medial and lateral plantar branch communication

III. Mechanism

  1. Repetitive Trauma
  2. Secondary Fibrosis
  3. Painful fusiform swelling of nerve

IV. Epidemiology

  1. Women more often affected than Men

V. Symptoms

  1. Severe burning pain at third web space
  2. Numbness in affected toes
  3. Radiation of pain into third and fourth toes
  4. Provocative
    1. Worse with activity
    2. Aggravated by tight shoes
  5. Palliative
    1. Relieved by removing shoe
    2. Relieved by massaging foot

VI. Signs

  1. Mulder Click Test
    1. Dorsiflex the foot
    2. Squeezing the Metatarsals results in a "clicking" sound in Morton's Neuroma

VII. Differential Diagnosis

  1. Plantar Fasciitis (if affecting tibial nerve in proximal foot)

VIII. Management: Conservative therapy

  1. Often does not provide relief
  2. Pad to separate third and fourth Metatarsals heads
  3. Avoid tight fitting shoes
  4. Morton's Neuroma Injection

IX. Management: Surgery

  1. Corticosteroid Injection
  2. Surgical Excision of Neuroma
    1. Indicated in failed conservative management

Images: Related links to external sites (from Bing)

Related Studies

Ontology: Morton's metatarsalgia (C0311337)

Concepts Disease or Syndrome (T047)
ICD10 G57.6
SnomedCT 30085007, 193150007, 367097000, 155078003, 193149007, 189172000
Italian Nevralgia di Morton, Metatarsalgia di Morton, Malattia di Morton, Neuroma di Morton
Dutch metatarsalgie van Morton, Morton-neuroom, Mortons neuroom, Morton; metatarsalgie, Morton; neuralgie, Morton; neuroom, interdigitaal; neuroom, metatarsalgie; Morton, neuralgie; Morton, neuroom; Morton, neuroom; interdigitaal, Mortonse neuralgie
French Métatarsalgie de Morton, Névrome de Morton, Maladie de Morton, Névralgie de Morton
German Morton-Metatarsalgie, Morton-Neurom, Morbus Morton, Morton-Neuralgie
Portuguese Metatarsalgia de Morton, Doença de Morton, Neuroma de Morton, Neuralgia de Morton
Spanish Metatarsalgia de Morton, neuroma interdigital, dedo de Morton, Neuroma de Morton, Enfermedad de Morton, enfermedad de Morton, metatarsalgia de Morton (trastorno), metatarsalgia de Morton, neuralgia de Morton, neuroma de Morton, Neuralgia de Morton
Japanese モートン中足骨痛, モートン神経痛, モートンチュウソクコツツウ, モートンシンケイツウ, モートン病, モートン神経腫, モートンビョウ, モートンシンケイシュ
English Morton Neuroma, Morton's Neuroma, morton neuroma, neuroma morton, morton's toe, Mortons metatarsalgia, morton toe, morton's toes, interdigital neuroma, morton's neuroma, morton's neuromas, mortons neuroma, mortons neuromas, morton's disease, morton's neuralgia, morton s neuromas, mortons toe, Mortons neuroma, morton's neuroma (diagnosis), Interdigital neuralgia (disorder), Morton neuroma (disorder), Morton disease, Morton's neuralgia, Morton's toe, Morton's disease, Morton's metatarsalgia, Morton's neuroma, Interdigital neuralgia, Interdigital neuroma, Morton metatarsalgia, Morton neuroma, Morton's metatarsalgia (disorder), Morton; metatarsalgia, Morton; neuralgia, Morton; neuroma, interdigital; neuroma, metatarsalgia; Morton, neuralgia; Morton, neuroma; Morton, neuroma; interdigital, Interdigital Nerve Scar, mortons metatarsalgia
Czech Mortonova neuralgie, Mortonova metatarzalgie, Mortonova nemoc, Mortonův neurom
Hungarian Morton-neuralgia, Morton-féle metatarsalgia, Morton-neuroma, Morton-szindróma