Navigating Beyond Neuromas: A Riveting Case Report Unveiling Intriguing Differential Diagnoses
Paula Suárez Sánchez1*, Armando Macera2, Jose Gallardo Roig3 and Carlos Martin Lopez4
1 Trauma and orthopaedic surgeon, Hospital la Moraleja, Madrid, Spain.
2 Trauma and orthopaedic surgeon, Hospital Infanta Elena, Madrid, Spain.
3 Trauma and orthopaedic surgeon, Hospital la Moraleja, Madrid, Spain.
4 Trauma and orthopaedic surgeon, Hospital la Moraleja, Madrid, Spain.
*Corresponding Author: Paula Sua rez Sa nchez MD, Trauma and orthopaedic surgeon, Hospital la Moraleja, Madrid, Spain.
DOI: https://doi.org/10.58624/SVOAOR.2024.04.072
Received: June 11, 2024 Published: June 28, 2024
Abstract
The purpose of this research was to evaluate the pathophysiology, diagnosis, and differentialdiagnosis of metatarsalgia by describing a clinical case of a rare lower limb injury, fibrolipomatous hamartoma of the plantar nerve (HFL). Material and Method: We present thecase of a 47-year-old patient with a one-year history of pain in the anterior region of the right foot, associated with paresthesia of the lesser toes and no history of trauma. Physical examination revealed hyperkeratosis on the third rocker over the 2nd metatarsal (MTT), localpain, and neuritic symptoms, along with a doubtful Mulder sign. X-rays showed a negative index with narrowing of the space in the second toe. Magnetic resonance imaging described findings suggestive of a possible Morton's neuroma in the second space. Initial conservative management was chosen. After the lack of response to conservative treatment, surgical intervention was decided, during which the digital nerve was visualized and excised. Subsequently, a Triple Weil osteotomy was performed on the second and third MTT to prevent transfer metatarsalgia. The postoperative period was uncomplicated, and the patient showed complete relief of symptoms without recurrence after surgical excision. HFL presentsas a rare benign tumor with an atypical location in the foot, generating symptoms similar to Morton's neuroma. The imperative need for a differential diagnosis with this entity is emphasized.
Keywords: Morton's Neuroma; Forefoot; Pathological Anatomy
Citation: Sanchez PS, Macera A, Roig JG, Lopez CM. Navigating Beyond Neuromas: A Riveting Case Report Unveiling Intriguing Differential Diagnoses. SVOA Orthopaedics 2024, 4:3, 61-66. https://doi.org/10.58624/SVOAOR.2024.04.072