Imaging Considerations in Differentiating Plantar Plate Pathology and Webspace Neuroma

Area of Science:

• Orthopedics
• Radiology
• Podiatry

Background:

• Lesser toe pathologies are common.
• Plantar plate (PP) degeneration and tears can cause neuritic symptoms.
• Reactive pericapsular soft tissue thickening (pseudoneuroma) often accompanies PP dysfunction.

Purpose of the Study:

• To differentiate radiological findings of plantar plate degeneration/tear with pseudoneuroma from webspace neuroma.
• To review clinical presentations and imaging findings (radiography, sonography, MRI) of these conditions.
• To examine acquired toe deformities associated with each pathology.

Main Methods:

• Review of clinical presentations.
• Analysis of radiographic findings.
• Evaluation of sonographic and MRI characteristics.
• Correlation with acquired toe deformities.

Main Results:

• Plantar plate tears and degeneration can lead to pseudoneuroma, causing symptoms similar to webspace neuroma.
• Distinct imaging features differentiate PP pathology with pseudoneuroma from true webspace neuroma.
• Specific acquired toe deformities are associated with each condition.

Conclusions:

• Accurate radiological diagnosis is crucial for managing lesser toe pain.
• Understanding the imaging spectrum of PP dysfunction and webspace neuroma aids in differential diagnosis.
• Imaging modalities like MRI and ultrasound are key to identifying these pathologies.