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Rheumatoid nodule presenting as Morton's neuroma
S Chaganti1, S Joshy, K Hariharan
1Department of Orthopaedics, Royal Gwent Hospital, Newport, UK. drchaganti@hotmail.co.uk
Summary
Rheumatoid nodules can mimic Morton's neuroma, coexisting in patients with or without rheumatoid arthritis. Surgical removal and arthritis management resolved symptoms, highlighting the importance of considering rheumatoid nodules in differential diagnoses.
Area of Science:
- Rheumatology
- Orthopedic Surgery
- Pathology
Background:
- Morton's neuroma is a common cause of forefoot pain.
- Rheumatoid nodules are a known extra-articular manifestation of rheumatoid arthritis.
- Differentiating between these conditions can be clinically challenging.
Observation:
- This study investigated patients presenting with symptoms suggestive of Morton's neuroma.
- Intermetatarsal rheumatoid nodules were identified in 5 out of 101 feet.
- Two patients exhibited bilateral involvement, and histology confirmed coexisting rheumatoid nodules and Morton's neuroma in four cases.
Findings:
- Rheumatoid nodules can present identically to Morton's neuroma.
- A rheumatoid nodule can coexist with Morton's neuroma.
- Surgical intervention led to asymptomatic outcomes for patients in this study.
Implications:
- Rheumatoid nodules should be included in the differential diagnosis for Morton's neuroma.
- Consideration is warranted even in patients without a prior rheumatoid arthritis diagnosis or known rheumatoid antibodies.
- Early diagnosis and appropriate management of rheumatoid nodules can prevent misdiagnosis and improve patient outcomes.
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