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Rheumatoid nodule presenting as a Morton's neuroma in the foot: An important differential diagnosis to consider
Ravi Patel1,2, Raghav Nand3, Dakshinamurthy Sunderamoorthy3
1Department of Trauma and Orthopedics, The Princess Royal Hospital, Apley Castle, Telford, TF1 6TF, UK.
Abstract:
A 51-year-old lady with a background of rheumatoid arthritis presented to the foot and ankle clinic with pain and a typical history of Morton's neuroma. Examination revealed a palpable swelling over the right foot in the third intermetatarsal space. Following failed conservative management, the patient underwent excision of the neuroma. Histology revealed of necrotizing granulomas with peripheral palisading and no evidence of features specific to a neuroma. This has rarely been described previously and supports the concept of rheumatoid synovitis and nodules producing symptoms mimicking Morton's neuroma/metatarsalgia. Level of clinical evidence: 4.
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