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Difference between revisions of "Morton neuroma"
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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Morton neuroma - alt 2 -- intermed mag.jpg | |||
| Width = | |||
| Caption = Morton neuroma. [[H&E stain]]. | |||
| Synonyms = plantar interdigital neuroma | |||
| Micro = extensive fibrosis around and within the nerve, digital artery +/-[[thrombosis]] +/-arterial thickening | |||
| Subtypes = | |||
| LMDDx = [[traumatic neuroma]], [[plexiform neurofibroma]] | |||
| Stains = | |||
| IHC = | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Site = [[soft tissue lesion|soft tissue]] of the foot | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = | |||
| Signs = | |||
| Symptoms = foot pain | |||
| Prevalence = not common | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = benign | |||
| Other = | |||
| ClinDDx = | |||
| Tx = +/-surgical excision | |||
}} | |||
'''Morton neuroma''' is a benign lesion of the foot that can be grouped with the [[peripheral nerve sheath tumours]]. | |||
It is also known as a '''plantar interdigital neuroma'''.<ref name=pmid22995258>{{Cite journal | last1 = Makki | first1 = D. | last2 = Haddad | first2 = BZ. | last3 = Mahmood | first3 = Z. | last4 = Shahid | first4 = MS. | last5 = Pathak | first5 = S. | last6 = Garnham | first6 = I. | title = Efficacy of corticosteroid injection versus size of plantar interdigital neuroma. | journal = Foot Ankle Int | volume = 33 | issue = 9 | pages = 722-6 | month = Sep | year = 2012 | doi = DOI: 10.3113/FAI.2012.0722 | PMID = 22995258 }}</ref> | |||
==General== | |||
*Benign foot condition. | |||
*Uncommon. | |||
*Usually interdigital nerves. | |||
Etiology: | |||
*Indirect nerve trauma. | |||
Clinical:<ref name=Ref_Sternberg4>{{Ref Sternberg4|243}}</ref> | |||
*Foot pain. | |||
Note: | |||
*Morton's neuroma is related [[traumatic neuroma]]:<ref>{{Ref_PSNP|238}}</ref> | |||
**The difference is that in ''traumatic neuroma'' the nerve is usually transected; in ''Morton's neuroma'' the nerve is chronically compressed. | |||
==Microscopic== | |||
Features:<ref name=Ref_Sternberg4>{{Ref Sternberg4|243}}</ref> | |||
*Extensive fibrosis around and within the nerve. | |||
*Digital artery: | |||
**+/-[[Thrombosis]]. | |||
**+/-Arterial thickening. | |||
DDx: | |||
*[[Traumatic neuroma]]. | |||
*[[Plexiform neurofibroma]]. | |||
===Images=== | |||
www: | |||
*[http://www.tumorlibrary.com/case/detail.jsp?image_id=2324 Morton neuroma (tumorlibrary.com)]. | |||
*[http://ars.els-cdn.com/content/image/1-s2.0-S1027811711000863-gr1.jpg Perineural fibrosis (els-cdn.com)].<ref>URL: [http://www.sciencedirect.com/science/article/pii/S1027811711000863 http://www.sciencedirect.com/science/article/pii/S1027811711000863]. Accessed on: 27 December 2012.</ref> | |||
<gallery> | |||
Image: Morton neuroma -- low mag.jpg | Morton neuroma - low mag. (WC) | |||
Image: Morton neuroma -- intermed mag.jpg | Morton neuroma - intermed. mag. (WC) | |||
Image: Morton neuroma -- high mag.jpg | Morton neuroma - high mag. (WC) | |||
Image: Morton neuroma -- very high mag.jpg | Morton neuroma - very high mag. (WC) | |||
</gallery> | |||
<gallery> | |||
Image: Morton neuroma - alt 1 -- intermed mag.jpg | Morton neuroma - intermed. mag. (WC) | |||
Image: Morton neuroma - alt 2 -- intermed mag.jpg | Morton neuroma - intermed. mag. (WC) | |||
Image: Morton neuroma - alt -- high mag.jpg | Morton neuroma - high mag. (WC) | |||
</gallery> | |||
==Sign out== | |||
<pre> | |||
LESION, THIRD WEB SPACE OF RIGHT FOOT ("MORTON'S NEUROMA"), EXCISION: | |||
- CONSISTENT WITH MORTON'S NEUROMA. | |||
</pre> | |||
===Micro=== | |||
The sections show soft tissue with larger nerves with extensive fibrosis around and within the nerve. There is no significant nuclear atypia. Mitotic activity is not readily apparent. | |||
==See also== | |||
*[[Peripheral nerve sheath tumours]]. | |||
*[[Neuroma]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Peripheral nerve sheath tumours]] | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||