Morton neuroma and intermetatarsal bursitis

Case contributed by Chris O'Donnell


Pain on weight-bearing in the 3rd/4th web space with electric shock sensation in both toes.

Patient Data

Age: 40 years
Gender: Female

Partially compressive heterogeneous mass in the 3rd webspace 

Enhancing solid mass in the third web space inferiorly with smaller non-enhancing fluid signal superiorly. 

Case Discussion

This case shows the typical findings of Morton neuroma and bursitis between the metatarsal heads.  Both conditions occur due to narrow shoes with compression/friction of the metatarsal heads when walking. Bursitis is bright on T2 with rim enhancement whereas the "neuroma" (actually perineural fibrosis) is of relatively low signal on T2 and shows patchy enhancement. Almost always between the 3rd and 4th metatarsal heads and very adequately visualized on ultrasound using a dorsal approach and placing a thumb on the plantar aspect and pushing up towards the probe.

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