Diagnosis of Morton’s Neuroma

Clinical diagnosis of this pathological condition is simple. First of all, it is based on the characteristic localization of pain. During palpation of the 3rd interplusar gap for 30–60 s, the patient, as a rule, begins to experience numbness and a burning sensation. Movement disorders are uncharacteristic. Sensory disturbances confirm neural damage.
Speaking of instrumental studies of Morton’s metatarsalgia, it should be noted that magnetic resonance imaging, unfortunately, does not always confirm the clinical diagnosis and in some cases gives questionable results. Performing computed tomography of the foot rarely gives any information due to the lack of mineral deposits in this soft tissue formation. However, due to X-ray methods, it is sometimes possible to determine the bone bite in the place of compression of the neuroma.
Ultrasound examination is one of the leading methods for diagnosing the condition of soft-tissue structures of the foot. However, in our country, the use of ultrasound for the diagnosis of diseases of the peripheral nerves is not sufficiently developed.
The regression of pain syndrome after the treatment and diagnostic blockade of the interplusal nerve with a solution of a local anesthetic is a convincing indication in favor of neuroma.
Pain in the foot and fingers is often observed in clinical practice, in most cases it is caused by deformity of the foot, which occurs in various pathological conditions, in particular with flat-footed or chronic Achilles tendinitis. However, with significant deformity of the feet, a pronounced pain syndrome does not always develop, as, for example, in patients with hereditary spastic paraplegia.
Differential diagnosis of Morton’s Neuroma is conducted with diseases such as synovitis of the metatarsophalangeal joint, stress fractures of the metatarsal bones and metatarsophalangeal joint arthritis, osteonecrosis of the metatarsal heads, neoplastic lesions of bones, lumbar spine disease, radiating pain in the intertarsal gaps.

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