Morton neuroma

Discussion:

Morton neuroma denotes a focal perineural fibrosis most often located in the third interdigital web space between the 3rd and 4th metacarpophalangeal joints leading to a fusiform enlargement of a common plantar digital nerve 1. Morton neuromas are a common cause of forefoot pain and on MRI they are characterized by a dumbbell-shaped contrast-enhancing lesion as in this case.

Splayfoot is an abnormal widening of the forefoot associated with flattening of the transverse arch of the foot and is associated with hallux valgus and bunionette deformity.

Radiographically it has been defined as an increase of the first intermetatarsal angle >12° and the fourth-fifth intermetatarsal angle of >8° 2  and the angles on the weight-bearing dorsoplantar foot radiograph of this case do not suggest a splayfoot deformity.

Other differential diagnoses of plantar forefoot pain include adventitial bursitisplantar plate tear, metatarsal stress injury, or peripheral nerve sheath tumors.

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