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]].
'''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>
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==
==General==
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Clinical:<ref name=Ref_Sternberg4>{{Ref Sternberg4|243}}</ref>  
Clinical:<ref name=Ref_Sternberg4>{{Ref Sternberg4|243}}</ref>  
*Foot pain.
*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==
==Microscopic==
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===Images===
===Images===
www:
*[http://www.tumorlibrary.com/case/detail.jsp?image_id=2324 Morton neuroma (tumorlibrary.com)].
*[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>
*[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==
==Sign out==
<pre>
<pre>
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==See also==
==See also==
*[[Peripheral nerve sheath tumours]].
*[[Peripheral nerve sheath tumours]].
*[[Neuroma]].


==References==
==References==

Latest revision as of 07:02, 9 November 2014

Morton neuroma
Diagnosis in short

Morton neuroma. H&E stain.

Synonyms plantar interdigital neuroma

LM extensive fibrosis around and within the nerve, digital artery +/-thrombosis +/-arterial thickening
LM DDx traumatic neuroma, plexiform neurofibroma
Site soft tissue of the foot

Symptoms foot pain
Prevalence not common
Prognosis benign
Treatment +/-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.[1]

General

  • Benign foot condition.
  • Uncommon.
  • Usually interdigital nerves.

Etiology:

  • Indirect nerve trauma.

Clinical:[2]

  • Foot pain.

Note:

  • Morton's neuroma is related traumatic neuroma:[3]
    • The difference is that in traumatic neuroma the nerve is usually transected; in Morton's neuroma the nerve is chronically compressed.

Microscopic

Features:[2]

  • Extensive fibrosis around and within the nerve.
  • Digital artery:

DDx:

Images

www:

Sign out

LESION, THIRD WEB SPACE OF RIGHT FOOT ("MORTON'S NEUROMA"), EXCISION:
- CONSISTENT WITH MORTON'S NEUROMA.

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

References

  1. Makki, D.; Haddad, BZ.; Mahmood, Z.; Shahid, MS.; Pathak, S.; Garnham, I. (Sep 2012). "Efficacy of corticosteroid injection versus size of plantar interdigital neuroma.". Foot Ankle Int 33 (9): 722-6. doi:DOI: 10.3113/FAI.2012.0722. PMID 22995258.
  2. 2.0 2.1 Mills, Stacey E; Carter, Darryl; Greenson, Joel K; Oberman, Harold A; Reuter, Victor E (2004). Sternberg's Diagnostic Surgical Pathology (4th ed.). Lippincott Williams & Wilkins. pp. 243. ISBN 978-0781740517.
  3. Perry, Arie; Brat, Daniel J. (2010). Practical Surgical Neuropathology: A Diagnostic Approach: A Volume in the Pattern Recognition series (1st ed.). Churchill Livingstone. pp. 238. ISBN 978-0443069826.
  4. URL: http://www.sciencedirect.com/science/article/pii/S1027811711000863. Accessed on: 27 December 2012.