Pseudoneuroma and complete 2nd toe lateral plantar plate tear (MRI)

Case contributed by Dai Roberts
Diagnosis almost certain


2nd toe pain and plantar swelling. ?Morton neuroma

Patient Data

Age: 45 years
Gender: Female

Complete tear of the lateral 2nd toe plantar plate, centered on the lateral accessory collateral ligament, with partial extension into both the central plantar plate and lateral proper collateral ligament. Contouring the plantar plate tear is an area of fibrosis which extends into the 2nd intermetatarsal webspace.

The highlighted area outlines the pseudoneuroma in the 2nd intermetatarsal webspace. It predominantly contours the lateral 2nd toe plantar plate tear and is not equally positioned in the webspace.

Case Discussion

Pseudoneuroma are such called as they can be mistaken for Morton neuroma. Pseudoneuroma are areas of fibrosis adjacent to a plantar plate tear, and will contour the tear. This is opposed to a Morton neuroma which is central in the webspace. It can be more difficult to distinguish between the two entities on ultrasound.

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