Morton’s Neuroma

Morton’s neuroma is one of the most frequent causes of metatarsalgia, which mostly affects the third interosseous space. It is usually unilateral, but even in 15-21% of the cases, it is bilateral. On the other hand, the involvement of simultaneous adjacent spaces is rare. The most common symptom is pain of the neurotic type. Despite the fact that the diagnosis is eminently clinical, imaging studies look for thickening and/or increase in size of the interdigital plantar nerve and rule out differential diagnosis. The recommended studies are ultrasonography (US) and magnetic resonance imaging (MRI). The initial treatment is conservative, using footwear modification, insoles, and corticoid infiltration. Surgical treatment consists in the neuroma resection (neurectomy) by means of a dorsal approach, being the most effective method in our experience for this pathology. If symptoms relapse, revision surgery through a plantar approach is recommended to allow nerve plantar branch identification and resection (more frequent cause for symptoms relapse).