Search Results (2)

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. Full article

Intermetatarsal bursitis (IMB) is an inflammation of the intermetatarsal bursas. The condition causes forefoot pain with symptoms similar to those of Morton’s neuroma (MN). Some studies suggest that IMB is a contributing factor to the development of MN, while others describe the condition as a differential diagnosis. Among patients with rheumatic diseases, IMB is frequent, but the scope is yet to be understood. The aim of this paper was to investigate the diagnostic considerations of IMB and its role in metatarsalgia by a systematic review approach. We identified studies about IMB by searching the electronic databases Pubmed, Embase, Cochrane Library, and Web of Science in September 2022. Of 1362 titles, 28 met the inclusion criteria. They were subdivided according to topic: anatomical studies (n = 3), studies of patients with metatarsalgia (n = 10), and studies of patients with rheumatic diseases (n = 15). We conclude that IMB should be considered a cause of pain in patients with metatarsalgia and patients with rheumatic diseases. For patients presenting with spreading toes/V-sign, IMB should be a diagnostic consideration. Future diagnostic studies about MN should take care to apply a protocol that is able to differ IMB from MN, to achieve a better understanding of their respective role in forefoot pain. Full article