Morton's neuroma pathophysiology

Morton's neuroma Microchapters
Home
Patient Information
Overview
Historical Perspective
Pathophysiology
Causes
Differentiating Morton's Neuroma from other Diseases
Epidemiology and Demographics
Risk Factors
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
X Ray
CT
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Morton's neuroma pathophysiology On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Morton's neuroma pathophysiology All Images X-rays Echo and Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Morton's neuroma pathophysiology
CDC on Morton's neuroma pathophysiology
Morton's neuroma pathophysiology in the news
Blogs on Morton's neuroma pathophysiology
Directions to Hospitals Treating Morton's neuroma
Risk calculators and risk factors for Morton's neuroma pathophysiology

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [8]; Associate Editor(s)-in-Chief: Sara Mohsin, M.D.[9]

Overview

Morton's neuroma is associated with symptomatic collapse of the transverse arch by perineural fibrosis around a plantar digital nerve of the foot due to chronic traction and increased pressure/compression on the interdigital nerve. It is located at the third intermetatarsal space most commonly (between third and fourth metatarsals), and sometimes second or fourth interspaces or bifurcation of the fourth plantar digital nerve. Gross pathological features of morton's neuroma include adherent fibrofatty tissue, small, firm, oval, yellowish-white, slowly growing, palpable nodule on skin (no discoloration of skin on the top of nodule) and </=2cm in size. Histopathological analysis is characterized by extensive fibrosis around and within the nerve, digital artery, thrombosis, epineural and endoneural arterial thickening/vascular hyalinization, and degenerated/demyelinated axons.

Pathophysiology

Pathogenesis

• Morton's neuroma is associated with symptomatic collapse of the transverse arch by perineural fibrosis around a plantar digital nerve of the foot due to chronic traction and increased pressure/compression on the interdigital nerve

Location

• Morton neuroma is characterized by being located at the:
  • Third intermetatarsal space most commonly (between third and fourth metatarsals)
  • Second or fourth interspaces
  • Bifurcation of the fourth plantar digital nerve

Gross pathology

• On gross pathology, characteristic findings of morton's neuroma, include:
  • Adherent fibrofatty tissue
  • Small, firm, oval, yellowish-white, slowly growing, palpable nodule on skin (no discoloration of skin on the top of nodule)
  • </=2cm in size

Histopathology

• On microscopic histopathological analysis, characteristic findings of morton's neuroma include:
  • Extensive fibrosis around and within the nerve
  • Digital artery
  • Thrombosis
  • Epineural and endoneural arterial thickening/vascular hyalinization
  • Degenerated/demyelinated axons

H&E stain of Morton's neuroma, very high magnification [1]

H&E stain of Morton's neuroma, low magnification [2]	H&E stain of Morton's neuroma, High magnification [3]	H&E stain of Morton's neuroma, Intermediate magnification [4]	H&E stain of Morton's neuroma, Intermediate magnification [5]
H&E stain of Morton's neuroma, Intermediate magnification [6]	H&E stain of Morton's neuroma, High magnification [7]