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Morton's neuroma is a benign neuroma of an intermetatarsal plantar nerve, most commonly of the second and third intermetatarsal spaces (between the second/third and third/fourth metatarsal heads; the first is of the big toe), which results in the entrapment of the affected nerve.
Mulder's sign is a physical exam finding associated with Morton's neuroma, which may be elicited while the patient is in the supine position on the examination table. The pain of the neuroma, as well as a click, can be produced by squeezing the two metatarsal heads together with one hand, while concomitantly putting pressure on the interdigital space with the other hand.
One cause of metatarsalgia is Morton's neuroma. When toes are squeezed together too often and for too long, the nerve that runs between the toes can swell and get thicker. This swelling can make it painful when walking on that foot. High-heeled, tight, or narrow shoes can make pain worse. This is common in runners, particularly of long distance.
Synonyms include scar neuroma, amputation neuroma, or pseudoneuroma. Morton's neuroma (a mononeuropathy of the foot) is another example of the more general usage of the term neuroma . Some prefer the term "Morton's metatarsalgia ", thus avoiding the term neuroma and its association with tumors.
Patients with hereditary motor and sensory neuropathies are diagnosed through a physical evaluation that looks for muscle atrophy, weakness, and sensory responses. [3] In addition to this, electromyography and motor nerve conduction tests can help clinicians decide what type of motor and sensory neuropathy it is and how severe the disease is.
Tinel's sign takes its name from French neurologist Jules Tinel (1879–1952), who wrote about it in a journal article published in October 1915. [3] [4] [5] German neurologist Paul Hoffmann independently also published an article on tinel sign six months earlier, in March 1915.
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