• 1. 

    Symeonidis PD, Iselin LD & Simmons N et al.: Prevalence of interdigital nerve enlargements in an asymptomatic population. Foot Ankle Int 33 : 543, 2012.

  • 2. 

    Thomas JL, Blitch EL & Chaney DM et al.: Diagnosis and treatment of forefoot disorders: section 3. Morton's intermetatarsal neuroma. J Foot Ankle Surg 48 : 251, 2009.

  • 3. 

    Sullivan JD: Neuroma diagnosis by means X-ray evaluation. J Foot Ankle Surg 6 : 45, 1967.

  • 4. 

    Jain S & Mannan K: The diagnosis and management of Morton's neuroma. Foot Ankle Spec 8 : 307, 2013.

  • 5. 

    Grace TS, Sunshein K & Jones R et al.: Metatarsus proximus and digital divergence: association with intermetatarsal neuromas. JAPMA 83 : 406, 1993.

  • 6. 

    Kankanala G & Jain AS: The operational characteristics of ultrasonography for the diagnosis of plantar intermetatarsal neuroma. J Foot Ankle Surg 46 : 213, 2007.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7. 

    Terk MR, Kwong PK & Suthar M et al.: Morton's neuroma: evaluation with MR imaging performed with contrast enhancement and fat suppression. Radiology 189 : 239, 1993.

  • 8. 

    William JW, Meaney J & Whitehouse GH et al.: MRI in the investigation of Morton's neuroma: which sequences? Clin Radiol 52 : 46, 1997.

  • 9. 

    Zanetti M, Ledermann T & Zollinger H et al.: Efficacy of MR imaging in patients suspected of having Morton's neuroma. Am J Roentgenol 168 : 529, 1997.

  • 10. 

    Lee MJ, Kim S & Huh YM et al.: Morton neuroma: evaluated with ultrasonography and MR imaging. Korean J Radiol 8 : 148, 2007.

  • 11. 

    Erickson SJ, Canale PB & Carrera GF et al.: Interdigital (Morton) neuroma: high-resolution MR imaging with a solenoid coil. Radiology 181 : 833, 1991.

  • 12. 

    Zanetti M Weishaupt D: MR imaging of the forefoot: Morton neuroma and differential diagnoses. Semin Musculoskelet Radiol 9 : 175, 2005.

  • 13. 

    Kay D & Bennett GL: Morton's neuroma. Foot Ankle Clin 8 : 49, 2003.

  • 14. 

    Giakoumis M, Ryan J & Jani J: Histologic evaluation of intermetatarsal Morton's neuroma. JAPMA 103 : 218, 2013.

  • 15. 

    O'Connor K, Johnson J & McCormick J et al.: Correlation of clinical, operative, and histopathologic diagnosis of interdigital neuroma and the cost of routine diagnosis. Foot Ankle Int 37 : 70, 2015.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16. 

    Adams WR II: Morton's neuroma. Clin Podiatr Med Surg 27 : 535, 2010.

  • 17. 

    Wu K: Morton's interdigital neuroma: a clinical review of its etiology, treatment, and results. J Foot Ankle Surg 35 : 112, 1996.

  • 18. 

    Ormeci T, Olcay G & Malkoc M et al.: Diagnostic value of elastography in the diagnosis of intermetatarsal neuroma. J Foot Ankle Surg 55 : 720, 2016.

  • 19. 

    Mahadevan D, Venkatesan M & Bhatt R et al.: Diagnostic accuracy of clinical tests for Morton's neuroma compared with ultrasonography. J Foot Ankle Surg 54 : 549, 2015.

  • 20. 

    Mann RA & Reynolds JC: Interdigital neuroma: a critical clinical analysis. Foot Ankle 3 : 238, 1983.

  • 21. 

    Friscia DA, Strom DE & Parr JW et al.: Surgical treatment for primary interdigital neuroma. Orthopedics 14 : 669, 1991.

  • 22. 

    Rungprai C, Cychosz, BS & Phreuetthiphat O et al.: Simple neurectomy versus neurectomy with intramuscular implantation for interdigital neuroma: a comparative study. Foot Ankle Int 36 : 1412, 2015.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23. 

    Bradley N, Miller WA & Evans JP: Plantar neuroma: analysis of results following surgical excision in 145 patients. South Med J 69 : 853, 1976.

  • 24. 

    Valero J, Gallart J & Gonzalez D et al.: Multiple interdigital neuromas: a retrospective study of 279 feet with 462 neuromas. J Foot Ankle Surg 54 : 320, 2015.

  • 25. 

    Claassen L & Bock K Ettinger, et al: Role of MRI in detection of Morton's neuroma. Foot Ankle Int 35 : 1002, 2014.

  • 26. 

    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 85 : 999, 2003.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27. 

    Pastides P, El-Sallakh S & Charalambides C: Morton's neuroma: a clinical versus radiological diagnosis. Foot and Ankle Surg 18 : 22, 2012.

  • 28. 

    Owens R, Guthrie H & Gougoulias N et al.: Morton's neuroma: accuracy of clinical assessment. Orthop Proc 93 : 312, 2011.

  • 29. 

    Coughlin MJ: Second metatarsophalangeal instability in the athlete. Foot Ankle 14 : 309, 1999.

Sex Correlation to the Prevalence of Pedal Neuromas in Various Interspaces: A Retrospective Study

Restricted access

Background

Morton's neuromas are abnormalities of the common digital nerve branch located between the lesser metatarsal heads. Historically, interdigital (Morton's) neuromas have been characterized as being most common in the third interspace and in females. The principal investigator observed Morton's neuromas commonly in the second and third interspaces in both sexes. To our knowledge, no literature exists to evaluate Morton's neuroma location with a focus on each sex independently. The present study evaluates Morton's neuroma interspace location and whether there is a variation by sex.

Methods

In this retrospective study, 582 deidentified magnetic resonance imaging reports with a diagnosis code for Morton's neuroma were evaluated for patients scanned from January 2, 2015, through April 19, 2016. Incomplete records and those with radiologist findings inconsistent with Morton's neuroma were eliminated. For the remaining 379 patients, data were collected on sex, laterality, history of trauma, plantar plate tear, age, and interspace location. Special focus was given to second and third interspace Morton's neuromas. Data were evaluated using the Pearson χ2 and independent-samples Mann-Whitney U tests, with P < .05 indicating statistical significance.

Results

No statistically significant distribution between sex and second and third interspace Morton's neuromas was noted. Right vs left foot, age, and history of trauma did not vary statistically significantly between sexes. There was a statistically significant difference between the presence of plantar plate tears between sexes. Male patients with Morton's neuromas were found to have a higher rate of plantar plate tears (P = .01).

Conclusions

This study found that there were no statistically significant differences between sexes and Morton's neuromas location, laterality, or age.

Department of Podiatry, Johnson Memorial Hospital, Franklin, IN.

Dr. William M. Scholl College of Podiatric Medicine, North Chicago, IL.

Department of Podiatry, St. Vincent Hospital, Indianapolis, IN.

Office of Research and Clinical Trials, St. Vincent Hospital, Indianapolis, IN.

Corresponding author: Patrick A. DeHeer, DPM, Johnson Memorial Hospital, 1159 W Jefferson St, Suite 204, Franklin, IN 46131. (padeheer@apma.org)