Traumatic neuroma

Traumatic neuromas may occur from acute or chronic injury to a nerve.

The patient presents with a focal area of pain and tenderness to palpation. There should be a history of injury to the area. Surgery is a common source of traumatic neuromas (e.g. ilioinguinal pain post herniorrhaphy). 

They may develop 1-12 months after nerve injury.

A traumatic neuroma is not a neoplasm, but is formed from one of two main processes:

  • spindle neuroma from a reactive fibroinflammatory disorganised regeneration around a nerve after an injury, such as traction injury or chronic repetitive stress. Morton neuroma is an example
  • terminal neuroma (such as "stump neuroma") which can occur after  transection of the nerve (e.g. limb amputation)
Ultrasound
  • at the site of the patient's pain
    • swollen nerve, occasionally mass-like (comparison with opposite side is often helpful)
    • hypoechoic
    • loss of normal fibrillar pattern
    • usually small, but may be as large as 5 cm
  • the parent nerve of some small nerve may difficult or impossible to discern
MRI
  • fusiform swelling of a nerve or a bulbous mass at a nerve end
    • the parent nerve of some small nerve may difficult or impossible to discern
  • T2/STIR
    • inhomogeneous hyperintensity
    • may have a hypointense rim
  • T1 C+ (Gd): variable contrast enhancement

Treatment varies according to local expertise, but can range from excision, anesthetic injection, or alcohol ablation.

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Article Information

rID: 35264
Synonyms or Alternate Spellings:
  • Stump neuroma
  • Traumatic neuromas
  • Stump neuromas

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