Imaging Considerations in Differentiating Plantar Plate Pathology and Webspace Neuroma

Myriad pathologies affect the lesser toes. In this article, the focus is on the challenging radiological differential diagnosis of plantar plate (PP) degeneration and tear versus webspace neuroma. It is now understood that PP tear and even degeneration without tear is most accompanied by reactive pericapsular soft tissue thickening (pseudoneuroma), which contributes to neuritic symptoms that are often indistinguishable from webspace neuroma. In this article, the authors will review the differing clinical presentations and radiographic, sonographic, and MRI findings of these entities and the different acquired toe deformities that occur in PP dysfunction with pseudoneuroma, versus webspace neuroma.