38.107.191.110
MedPix® Medical Image DatabaseDisease Topic 3546
(Reviewed and Approved) :: Link to this Topic
Click Here for MedPix®-2
» » - - Print Topic - - « «
Contributor: Hayden O Jack - National Capital Consortium
Scroll to Bottom to Display Images (if available)
More Like This ? Morton's Neuroma
Factoid 3546 - Created: 2002-01-11 00:31:00-05 - Modified: 2004-09-14 04:39:51-04
ACR Codes: 4.3
Morton’s neuroma is a non-neoplastic perineural fibrosis of an interdigital nerve. It most commonly involves the lateral branch of the medial plantar nerve between the third and fourth metatarsal heads. Less commonly involved are the second and fourth interspaces. Female to male ratio is 18:1 and usually occurs between ages 40 – 60. Patients often present with pain and tenderness in the involved interspace. Mechanism of pain is thought to be compression of the nerve against the intermetatarsal ligament. Absence of a palpable mass is frequent.

Radiographic evaluation is usually normal. Anecdotal experience of Kransdorf and Murphey suggests that power Doppler sonography is a valuable adjunct, with lesions typically showing increased vascularity. T1 and T2-weighted MRI images usually demonstrate a low to intermediate signal intensity mass between the plantar aspects of the metatarsal heads. Conspicuity of the lesion is reduced on T2 weighted images, making differentiation between lesion and surrounding fat and muscle difficult. The most sensitive technique for depicting these lesions is fat-suppressed contrast enhanced images. In most cases, however, coronal T1 weighted images reveal the lesions. According to Stoller, this technique displays lesion hyperintensity in cases where conventional T2-weighted images either fail to demonstrate the lesion or show the lesion with decreased conspicuity.

The most successful treatment modality is excision of the neuroma and involved nerve segment. Other treatment options include neurolysis, steroid injection, ultrasound therapy, and surgical release of the transverse metatarsal ligament for decompression.
Reference(s):
Kransdorf, Mark J. and Murphey, Mark D. Imaging of Soft
Tissue Tumors. Philadelphia: W.B. Saunders Company,
1997.
Stoller, David W. Magnetic Resonance Imaging in
Orthopaedics and Sports Medicine: 2nd edition.
Philadelphia: Lippincott-Raven, 1997.
Display Images - || - Image Slide Sorter
Location:
MSK - Musculoskeletal
Sublocation:
none selected
Category:
Trauma
More Like This ? - Find Related Topics: Click on the Location, Sublocation, or Category Links Above
Send this Search to ... More Like This ?  - - CHORUS - - Google™
Prepared by: Hayden O Jack
Affiliation: National Capital Consortium - || - Author Profile
Approved by: Philip A Dinauer
Affiliation: Civilian Medical Center - || - Editor Profile
-


Use this MedPix® Visitor Feedback Form for Comments and Suggestions


MedPix® is sponsored by the Department of Radiology and Radiological Sciences, USUHS, Bethesda, MD
We do not accept paid advertisements.

This website is accredited by Health On the Net Foundation. Click to verify. We comply with the HONcode standard
for trustworthy health information:
verify here.


Text and Images may be Copyrighted © 1999 - 2009 by the Original Content Contributors.
Copyrighted materials are reproduced here with their Permission.

MedPix® is a Registered Trademark of USUHS :: The MedPix® Database Engine is Patented - USPTO No. 7,080,098
Portions of MedPix® are Copyright © 1999 - 2009 by J.G. Smirniotopoulos, M.D. & H. Irvine, M.D.
The MedPix® Classification Schema Copyright © 1999 - 2009 by J.G.Smirniotopoulos,M.D.
MedPix® has displayed more than   266,883,839   pages since 3 September 2000.

Database Successfully Disconnected