Morton's neuroma: A clinical versus radiological diagnosis

Foot Ankle Surg. 2012 Mar;18(1):22-4. doi: 10.1016/j.fas.2011.01.007. Epub 2011 Feb 16.


Background: The aim of our study was to compare the clinical versus radiological diagnosis of patients suffering from a Morton's neuroma.

Methods: Clinical assessments and pre-operative radiological imaging of patients who had excision of a Morton's neuromas were retrospectively compared.

Results: 43 neuromas were excised from 36 patients over 68 months. The commonest clinical symptoms were tenderness on direct palpation (100%), pain on weight bearing (91%) which was relieved by rest (81%). The most sensitive clinical sign was a Mulder's click. Clinical assessment had a sensitivity of 98% (42/43). Ultrasonography had a sensitivity of 90% (28/31) and magnetic resonance imaging had a sensitivity of 88% (14/16).

Conclusion: There is no absolute requirement for imaging patients who clinically have a Morton's neuroma. The two main indications for imaging are (a) an unclear clinical assessment and (b) cases when more than one web space is affected. Ultrasonography should be the investigation of choice.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Diagnosis, Differential
  • Female
  • Follow-Up Studies
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Male
  • Metatarsalgia / diagnosis*
  • Metatarsalgia / surgery
  • Metatarsophalangeal Joint / diagnostic imaging*
  • Metatarsophalangeal Joint / pathology*
  • Middle Aged
  • Pain Measurement / methods*
  • Retrospective Studies
  • Ultrasonography