Distended intermetatarsal head bursa
Chronic pain in the foot between the 3rd and 4th toes
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Distended intermetatarsal head bursa (between 3 and 4). No surrounding soft tissue swelling. 3rd and 4th MTPs are normal. No Morton neuroma.
Significance of this finding is not certain as it may be normal to have a bursa of up to 3 mm in width especially in the 3rd and 2nd interspaces. The asymmetry and localised pain suggests that the bursa is pathologically enlarged (inflamed). Injection of steroid and local anaesthetic under ultrasound control can be performed in an attempt to alleviate symptoms (i.e. both diagnostic and potentially therapeutic).