Morton’s neuroma is a benign swelling at the ball of the foot due to a nerve swelling that occur in a nerve. This commonly occur between the 3rd and 4th toes of your foot. The ligaments and bones put pressure on the nerve swelling which causes inflammation and irritation in that area giving rise to pain, tingling sensation, and numbness at the ball of the foot causing irritation in your foot.
Does Morton’s Neuroma Show Up On X-Ray?
Morton’s neuroma is a clinical diagnosis and usually investigations are not needed always to diagnose it. However, if there is any doubt or difficulty in arriving at a diagnosis the following investigations can be done.
X-rays. X-ray is a type of electromagnetic radiation; it is quite similar to visible light. But X-rays have higher energy levels and can penetrate through most objects even the human body. This X-rays are used to generate images of the internal structures in the body in order to take good look at those structures.
When you go to do an X-ray, what happens is you are placed between the X-ray generator and the X-ray detector. The X-rays pass through your body from the generator and body structures absorb different number of X-rays depending on the radiological density of the body tissue. Then, these form a black and white image on the X-ray detector of the internal body structures which is called a radiograph.
Bones has high amount of calcium levels which have a higher atomic number therefore, bones absorb X-rays well and produce a high contrast in the detector. So, bones appear white in color. Whereas, X-rays travel better through fat, muscles and through air filled cavities which are less dense radiologically. Soft tissues appear grey in color and the structures are not clearly visible in the radiograph. Air appears black in color and can be recognized better than the soft tissues.
Morton’s neuroma is a nervous tissue swelling therefore; it is not clearly seen in an X-ray. But other conditions causing pain in the foot can be ruled out by doing an X-ray (stress fracture).
Ultrasound Scan. USS is quite accurate and good at diagnosing Morton’s neuroma. USS is less invasive, cheap, and less time-consuming investigation that can be done easily. It’s almost as accurate as an MRI scan.
MRI. MRI visualizes the neuroma well and accuracy is about 85-95%. However, this investigation is expensive and time consuming.
Symptoms Of Morton’s Neuroma
Pain In The Ball Of The Foot
Sharp, burning, severe pain felt in the ball of the foot, radiating towards the adjacent toes, the pain occurs after walking for a short period. Pain is relieved by having rest, removing the footwear and by massaging the area. The pain worsens with time.
Lump which is felt from outside is not usually present.
Other Symptoms of Morton’s Neuroma
- Numbness – in the affected area
- Pins and needle feeling – tingling and prickling sensation is felt over the affected area.
- Sensation of something inside the foot
Signs Of Morton’s Neuroma
- The presence of following signs is suggestive Morton’s neuroma
- Tenderness at the 3rd and 4th web space or the web space that is involved
- Altered sensation between the web space
- Positive Mulder’s click
Conclusion
Morton’s neuroma is a benign swelling at the ball of the foot due to a nerve swelling that occurs in a nerve. This commonly occur between the 3rd and 4th toes of your foot. Morton’s neuroma is a clinical diagnosis and usually investigations are not needed always to diagnose it. However, if there is any doubt or difficulty in arriving at a diagnosis the following investigations can be done. X-ray, USS and MRI scan. X-ray is a type of electromagnetic radiation. Soft tissues appear grey in color and the structures are not clearly visible in the radiograph. Morton’s neuroma is a nervous tissue swelling therefore, it’s not clearly seen in an X-ray. But other conditions causing pain in the foot can be ruled out by doing an X-ray (stress fracture).
- NHS. (2021). Morton’s Neuroma https://www.nhs.uk/conditions/mortons-neuroma/
- RadiologyInfo.org. (2021). X-ray (Radiography) https://www.radiologyinfo.org/en/info.cfm?pg=xray
- RadiologyInfo.org. (2021). X-ray (Radiography) Haddad, S. L. (2015). Morton’s Neuroma: Updated Clinical Review
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