Distended intermetatarsal head bursa

Case contributed by Chris O'Donnell
Diagnosis almost certain

Presentation

Chronic pain in the foot between the 3rd and 4th toes

Patient Data

Age: 20 years
Gender: Female

Distended intermetatarsal head bursa (between 3rd and 4th). No surrounding soft tissue swelling. 3rd and 4th metatarsophalangeal Joints are normal. No Morton neuroma.

Case Discussion

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 2nd and 3rd intermetatarsal spaces. The asymmetry and localized pain suggest that the bursa is pathologically enlarged (inflamed). Injection of steroid and local anesthetic under ultrasound control can be performed in an attempt to alleviate symptoms (i.e. both diagnostic and potentially therapeutic).

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