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Morton Neuroma (Interdigital Neuroma)

Scott Goldberg, MD and J. Herbert Stevenson, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Painful condition of the webbed spaces of the toes

  • Features perineural fibrosis of the common digital nerve as it passes between metatarsals

    • The interspace between the 3rd and 4th me...

DIAGNOSIS

HISTORY

  • Most common complaint is pain localized to interspace between 3rd and 4th toes.

  • Pain is less severe when not bearing weight.

  • Pain, cramping, or numbness of the forefoot during weight be...

TREATMENT

GENERAL MEASURES

  • Stepwise treatment, with typical progression from conservative measures followed by infiltrative treatment, and ultimately surgical treatment.

  • Surgical treatments are the most...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

At diagnosis, or if no improvement after 3 months of conservative treatment, consider corticosteroid injection. 
  • May repeat injection if no improvement after 2 to ...

REFERENCES

1
Sharp RJ, Wade CM, Hennessy MS, et al. The role of MRI and ultrasound imaging in Morton’s neuroma and the effect of size of lesion on symptoms. J Bone Joint Surg Br.  2003;85(7):999–1...

ADDITIONAL READING

  • Jain S, Mannan K. The diagnosis and management of Morton’s neuroma: a literature review. Foot Ankle Spec.  2013;6(4):307–317. [View Abstract on OvidMedline]

  • Schreiber K, Khodae...

CODES

ICD10

  • G57.60 Lesion of plantar nerve, unspecified lower limb

  • G57.61 Lesion of plantar nerve, right lower limb

  • G57.62 Lesion of plantar nerve, left lower limb

ICD9

355.6 Lesion of plantar nerve 

SNOMED

...

CLINICAL PEARLS

  • Morton neuroma is usually a clinical diagnosis but can be further evaluated with US or MRI.

  • Typical treatment is stepwise with conservative, then infiltrative, and then operative treatm...

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