Morton’s Neuroma or Intermetatarsal Bursitis—A Prospective Diagnostic Study of Intermetatarsal Pain
<b>Background:</b> Intermetatarsal bursitis (IMB) is emerging as a diagnostic consideration for patients with forefoot pain. However, few investigations have been conducted into the incidence of IMB among patients with forefoot pain. The symptoms of IMB are described as mimicking those o...
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2025-05-01
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| author | Sif Binder Larsen Cecilie Mørck Offersen Eva Dyrberg Jens Kurt Johansen Naja Bjørslev Lange Birthe Højlund Bech Michael Bachmann Nielsen Søren Tobias Torp-Pedersen |
| author_facet | Sif Binder Larsen Cecilie Mørck Offersen Eva Dyrberg Jens Kurt Johansen Naja Bjørslev Lange Birthe Højlund Bech Michael Bachmann Nielsen Søren Tobias Torp-Pedersen |
| author_sort | Sif Binder Larsen |
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| description | <b>Background:</b> Intermetatarsal bursitis (IMB) is emerging as a diagnostic consideration for patients with forefoot pain. However, few investigations have been conducted into the incidence of IMB among patients with forefoot pain. The symptoms of IMB are described as mimicking those of Morton’s neuroma (MN). Currently, the best method to differentiate between MN and IMB is radiological evaluation. Based on this, the aim of this study was to investigate the incidence of IMB and MN in a prospective cohort of patients with intermetatarsal pain diagnosed with radiological evaluation and compared to a control group. <b>Methods:</b> This study included 26 patients and 13 controls. All participants underwent magnetic resonance imaging (MRI) and ultrasound (US) of one forefoot. <b>Results:</b> Among the 26 patients, 5 (19.2%) had MN and 14 (53.8%) had IMB on MRI compared to US, with which 25 (96.2%) cases of IMB and 0 with MN were identified. In the control group, both modalities found asymptomatic web space pathology in four cases (30.8%), and US identified normal intermetatarsal bursas in five cases. Additionally, our results indicate that MN patients have more severe pain and a longer history of pain compared to IMB patients. <b>Conclusions:</b> Based on our MRI results, we conclude that IMB is frequent in patients with intermetatarsal pain. Differentiation between MN and IMB with US is complex and should be performed with caution and an understanding of both conditions. Normal intermetatarsal bursas are also visible on US as hypoechoic but non-expansive masses. |
| format | Article |
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| language | English |
| publishDate | 2025-05-01 |
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| series | Diagnostics |
| spelling | doaj-art-4027aec60b814cc2b9931006d1cb03c82025-08-20T02:32:57ZengMDPI AGDiagnostics2075-44182025-05-011511133910.3390/diagnostics15111339Morton’s Neuroma or Intermetatarsal Bursitis—A Prospective Diagnostic Study of Intermetatarsal PainSif Binder Larsen0Cecilie Mørck Offersen1Eva Dyrberg2Jens Kurt Johansen3Naja Bjørslev Lange4Birthe Højlund Bech5Michael Bachmann Nielsen6Søren Tobias Torp-Pedersen7Department of Diagnostic Radiology, Rigshospitalet, 2100 Copenhagen, DenmarkDepartment of Diagnostic Radiology, Rigshospitalet, 2100 Copenhagen, DenmarkDepartment of Diagnostic Radiology, Rigshospitalet, 2100 Copenhagen, DenmarkDepartment of Orthopedic Surgery, Hvidovre Hospital, 2650 Hvidovre, DenmarkDepartment of Orthopedic Surgery, Bispebjerg and Frederiksberg Hospital, 2400 Copenhagen, DenmarkDepartment of Diagnostic Radiology, Rigshospitalet, 2100 Copenhagen, DenmarkDepartment of Diagnostic Radiology, Rigshospitalet, 2100 Copenhagen, DenmarkDepartment of Diagnostic Radiology, Rigshospitalet, 2100 Copenhagen, Denmark<b>Background:</b> Intermetatarsal bursitis (IMB) is emerging as a diagnostic consideration for patients with forefoot pain. However, few investigations have been conducted into the incidence of IMB among patients with forefoot pain. The symptoms of IMB are described as mimicking those of Morton’s neuroma (MN). Currently, the best method to differentiate between MN and IMB is radiological evaluation. Based on this, the aim of this study was to investigate the incidence of IMB and MN in a prospective cohort of patients with intermetatarsal pain diagnosed with radiological evaluation and compared to a control group. <b>Methods:</b> This study included 26 patients and 13 controls. All participants underwent magnetic resonance imaging (MRI) and ultrasound (US) of one forefoot. <b>Results:</b> Among the 26 patients, 5 (19.2%) had MN and 14 (53.8%) had IMB on MRI compared to US, with which 25 (96.2%) cases of IMB and 0 with MN were identified. In the control group, both modalities found asymptomatic web space pathology in four cases (30.8%), and US identified normal intermetatarsal bursas in five cases. Additionally, our results indicate that MN patients have more severe pain and a longer history of pain compared to IMB patients. <b>Conclusions:</b> Based on our MRI results, we conclude that IMB is frequent in patients with intermetatarsal pain. Differentiation between MN and IMB with US is complex and should be performed with caution and an understanding of both conditions. Normal intermetatarsal bursas are also visible on US as hypoechoic but non-expansive masses.https://www.mdpi.com/2075-4418/15/11/1339Morton’s neuromaintermetatarsal bursitis/bursaweb spaceultrasoundmagnetic resonance imagingdiagnostic criteria |
| spellingShingle | Sif Binder Larsen Cecilie Mørck Offersen Eva Dyrberg Jens Kurt Johansen Naja Bjørslev Lange Birthe Højlund Bech Michael Bachmann Nielsen Søren Tobias Torp-Pedersen Morton’s Neuroma or Intermetatarsal Bursitis—A Prospective Diagnostic Study of Intermetatarsal Pain Diagnostics Morton’s neuroma intermetatarsal bursitis/bursa web space ultrasound magnetic resonance imaging diagnostic criteria |
| title | Morton’s Neuroma or Intermetatarsal Bursitis—A Prospective Diagnostic Study of Intermetatarsal Pain |
| title_full | Morton’s Neuroma or Intermetatarsal Bursitis—A Prospective Diagnostic Study of Intermetatarsal Pain |
| title_fullStr | Morton’s Neuroma or Intermetatarsal Bursitis—A Prospective Diagnostic Study of Intermetatarsal Pain |
| title_full_unstemmed | Morton’s Neuroma or Intermetatarsal Bursitis—A Prospective Diagnostic Study of Intermetatarsal Pain |
| title_short | Morton’s Neuroma or Intermetatarsal Bursitis—A Prospective Diagnostic Study of Intermetatarsal Pain |
| title_sort | morton s neuroma or intermetatarsal bursitis a prospective diagnostic study of intermetatarsal pain |
| topic | Morton’s neuroma intermetatarsal bursitis/bursa web space ultrasound magnetic resonance imaging diagnostic criteria |
| url | https://www.mdpi.com/2075-4418/15/11/1339 |
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