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Diagnostics
Volume 15
Issue 11
10.3390/diagnostics15111339
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Article

Morton’s Neuroma or Intermetatarsal Bursitis—A Prospective Diagnostic Study of Intermetatarsal Pain

by
Sif Binder Larsen
1,2,*,
Cecilie Mørck Offersen
1,2,
Eva Dyrberg
1,
Jens Kurt Johansen
3,
Naja Bjørslev Lange
4,
Birthe Højlund Bech
1,
Michael Bachmann Nielsen
1,2,* and
Søren Tobias Torp-Pedersen
1
1
Department of Diagnostic Radiology, Rigshospitalet, 2100 Copenhagen, Denmark
2
Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark
3
Department of Orthopedic Surgery, Hvidovre Hospital, 2650 Hvidovre, Denmark
4
Department of Orthopedic Surgery, Bispebjerg and Frederiksberg Hospital, 2400 Copenhagen, Denmark
*
Authors to whom correspondence should be addressed.
Diagnostics 2025, 15(11), 1339; https://doi.org/10.3390/diagnostics15111339
Submission received: 8 April 2025 / Revised: 10 May 2025 / Accepted: 21 May 2025 / Published: 26 May 2025
(This article belongs to the Special Issue Novel Technologies in Orthopedic Surgery: Diagnosis and Management)
Review Reports Versions Notes

Abstract

Background: Intermetatarsal bursitis (IMB) is emerging as a diagnostic consideration for patients with forefoot pain. However, few investigations have been conducted into the incidence of IMB among patients with forefoot pain. The symptoms of IMB are described as mimicking those of Morton’s neuroma (MN). Currently, the best method to differentiate between MN and IMB is radiological evaluation. Based on this, the aim of this study was to investigate the incidence of IMB and MN in a prospective cohort of patients with intermetatarsal pain diagnosed with radiological evaluation and compared to a control group. Methods: This study included 26 patients and 13 controls. All participants underwent magnetic resonance imaging (MRI) and ultrasound (US) of one forefoot. Results: Among the 26 patients, 5 (19.2%) had MN and 14 (53.8%) had IMB on MRI compared to US, with which 25 (96.2%) cases of IMB and 0 with MN were identified. In the control group, both modalities found asymptomatic web space pathology in four cases (30.8%), and US identified normal intermetatarsal bursas in five cases. Additionally, our results indicate that MN patients have more severe pain and a longer history of pain compared to IMB patients. Conclusions: Based on our MRI results, we conclude that IMB is frequent in patients with intermetatarsal pain. Differentiation between MN and IMB with US is complex and should be performed with caution and an understanding of both conditions. Normal intermetatarsal bursas are also visible on US as hypoechoic but non-expansive masses.
Keywords: Morton’s neuroma; intermetatarsal bursitis/bursa; web space; ultrasound; magnetic resonance imaging; diagnostic criteria; prospective study Morton’s neuroma; intermetatarsal bursitis/bursa; web space; ultrasound; magnetic resonance imaging; diagnostic criteria; prospective study

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MDPI and ACS Style

Larsen, S.B.; Offersen, C.M.; Dyrberg, E.; Johansen, J.K.; Lange, N.B.; Bech, B.H.; Nielsen, M.B.; Torp-Pedersen, S.T. Morton’s Neuroma or Intermetatarsal Bursitis—A Prospective Diagnostic Study of Intermetatarsal Pain. Diagnostics 2025, 15, 1339. https://doi.org/10.3390/diagnostics15111339

AMA Style

Larsen SB, Offersen CM, Dyrberg E, Johansen JK, Lange NB, Bech BH, Nielsen MB, Torp-Pedersen ST. Morton’s Neuroma or Intermetatarsal Bursitis—A Prospective Diagnostic Study of Intermetatarsal Pain. Diagnostics. 2025; 15(11):1339. https://doi.org/10.3390/diagnostics15111339

Chicago/Turabian Style

Larsen, Sif Binder, Cecilie Mørck Offersen, Eva Dyrberg, Jens Kurt Johansen, Naja Bjørslev Lange, Birthe Højlund Bech, Michael Bachmann Nielsen, and Søren Tobias Torp-Pedersen. 2025. "Morton’s Neuroma or Intermetatarsal Bursitis—A Prospective Diagnostic Study of Intermetatarsal Pain" Diagnostics 15, no. 11: 1339. https://doi.org/10.3390/diagnostics15111339

APA Style

Larsen, S. B., Offersen, C. M., Dyrberg, E., Johansen, J. K., Lange, N. B., Bech, B. H., Nielsen, M. B., & Torp-Pedersen, S. T. (2025). Morton’s Neuroma or Intermetatarsal Bursitis—A Prospective Diagnostic Study of Intermetatarsal Pain. Diagnostics, 15(11), 1339. https://doi.org/10.3390/diagnostics15111339

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