foot ankle
Morton's Neuroma
intermediate
6 min
28 marks
6 questions
Clinical Scenario
A 48-year-old female office worker presents with a 12-month history of burning pain in the ball of her right foot radiating to the 3rd and 4th toes. Pain is worse in narrow shoes and high heels, with relief when removing footwear and massaging the foot. She describes occasional "electric shock" sensations. Clinical examination reveals tenderness in the third intermetatarsal space with positive Mulder's click. Sensation is diminished in the adjacent sides of the 3rd and 4th toes.
Ultrasound of the forefoot is provided.
Ultrasound of the forefoot is provided.
Clinical image for Morton's Neuroma
Image source: Open Access medical literature (NIH/PubMed Central) • CC-BY License
Questions
Question 1 (4 marks)
What is a Morton's neuroma? Describe the anatomy and pathophysiology.
Question 2 (5 marks)
Describe the clinical presentation and key examination findings. What differential diagnoses should you consider?
Question 3 (6 marks)
What investigations would you order? Describe the imaging findings and their interpretation.
Question 4 (5 marks)
Outline the non-operative management options for Morton's neuroma.
Question 5 (4 marks)
Describe the surgical technique for excision of Morton's neuroma. What are the key steps?
Question 6 (4 marks)
What are the complications of neuroma surgery? How would you manage a recurrent or stump neuroma?