Lachhab Abderrahim, Benghali Yassine, Maroc Mohamed, Nkhili Yassin, El Oumri Ahmed Amine
Faculty of Medicine, Mohammed First University, Oujda, MAR.
Physical Medicine and Rehabilitation, Centre Hospitalier Universitaire Mohammed VI Oujda, Oujda, MAR.
Cureus. 2025 Jun 17;17(6):e86184. doi: 10.7759/cureus.86184. eCollection 2025 Jun.
Metatarsalgia, a common cause of foot pain, significantly impairs quality of life and increases the risk of falls. Differentiating its underlying causes, such as Morton's neuroma and intermetatarsal bursitis, is crucial due to their distinct pathophysiology and management strategies. Clinical diagnosis can be challenging due to overlapping symptoms, underscoring the value of ultrasonography. This case report describes a 60-year-old woman with persistent metatarsalgia in the second and third interdigital spaces. While clinical findings suggested Morton's neuroma (positive Mulder test), ultrasound revealed a hypoechoic fluid collection measuring 8 × 4 mm with a thickened bursal wall, indicative of intermetatarsal bursitis, and, notably, no nerve thickening. This led to the exclusion of Morton's neuroma. The patient reported a pre-treatment Visual Analog Scale pain score of 8/10, which significantly improved to 2/10 following a steroid infiltration and custom insoles. This case highlights the importance of ultrasonography in accurately diagnosing metatarsalgia by differentiating between conditions with similar clinical presentations, thereby guiding appropriate treatment and improving patient outcomes.
跖痛症是足部疼痛的常见原因，会显著损害生活质量并增加跌倒风险。由于莫顿神经瘤和跖间滑囊炎等潜在病因具有不同的病理生理学和治疗策略，因此区分它们至关重要。由于症状重叠，临床诊断可能具有挑战性，这凸显了超声检查的价值。本病例报告描述了一名60岁女性，其第二和第三趾间间隙持续存在跖痛症。虽然临床检查结果提示莫顿神经瘤（穆德试验阳性），但超声显示一个8×4毫米的低回声液性暗区，滑囊壁增厚，提示跖间滑囊炎，值得注意的是，未见神经增粗。这导致排除了莫顿神经瘤。患者报告治疗前视觉模拟评分法疼痛评分为8/10，在进行类固醇注射和定制鞋垫后，疼痛评分显著改善至2/10。本病例强调了超声检查在通过区分临床表现相似的病症来准确诊断跖痛症方面的重要性，从而指导适当的治疗并改善患者预后。
