Rheumatoid nodule presenting as a Morton's neuroma in the foot: An important differential diagnosis to consider

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

Keywords

• Morton's neuroma
• Morton's metatarsalgia
• Intermetatarsal neuroma
• Rheumatoid nodule
• Forefoot pain