Morton Neuroma — SCE Rheumatology MCQ
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Correct answer: B — Morton neuroma (interdigital neuroma)
The diagnosis is Morton neuroma, an irritation and thickening involving a plantar digital nerve, most commonly in the third intermetatarsal space. Burning forefoot pain with paraesthesia radiating between the third and fourth toes is characteristic. A painful palpable Mulder click produced by compressing the forefoot strongly supports the diagnosis. Freiberg disease is osteonecrosis of a metatarsal head, usually the second, and causes MTP-region pain and stiffness rather than interdigital paraesthesia. Plantar fasciitis causes plantar heel pain, particularly on first steps. Gout usually presents as an acutely inflamed, swollen MTP joint, while a stress fracture causes focal bony tenderness and load-related pain without a Mulder click.
Reference: Royal National Orthopaedic Hospital NHS Trust. A Patient's Guide to Inter Digital Neuralgia (Morton's Neuroma), Diagnosis section. Updated 21 January 2026. https://www.rnoh.nhs.uk/patients-and-visitors/patient-information-guides/inter-digital-neuralgia-mortons-neuroma