Morton’s Neuroma; Surgical Exploration Is an Option in Symptomatic Patients with Normal Investigation

Syed Mohsin Ali,Mujtaba Ahmed Siddiqi

doi:10.4236/ojo.2018.811042

Abstract

Morton neuroma is well described problem to metatarsophalangeal Joint (MTPJ) Etiology of Morton’s Neuroma which has wide range of problems from trauma, and nerve hypertrophy etc. Clinical evaluation is very important for diagnosis and sometimes investigations like ultrasound or MRI scan are helpful for conformation of diagnosis. Management varies from orthotics, shoe modification, injections or surgical excision. We are reporting a case which showed importance of surgical exploration when investigation is normal and difficulty in making diagnosis clinically.

Highlights

Reporting a case of unusual presentation of Morton’s Neuroma, where all the investigations, MRI, Ultrasound, X-ray, CT scan, and CT SPECT were normal; Morton’s Neuroma has wide range of problems from trauma, and nerve hypertrophy etc
Management varies from orthotics, shoe modification, injections or surgical excision
This patient was referred from another hospital with chronic pain at in fore foot mainly at the 3 - 4 MT heads. She reported difficulty in walking and pain while wearing shoe. She was treated with different regimens of steroids and local anesthesia injection, orthotics and physiotherapy

Summary

Introduction

Reporting a case of unusual presentation of Morton’s Neuroma, where all the investigations, MRI, Ultrasound, X-ray, CT scan, and CT SPECT were normal; Morton’s Neuroma has wide range of problems from trauma, and nerve hypertrophy etc. Management of this condition is from use of orthotics, shoes modification, injections, physiotherapy and surgical excision. We would like to elaborate the importance of clinical examination and surgical exploration in such case when treating surgeon is not clear about the diagnosis and investigations are normal

Case Report

Discussion

Conclusions