Metatarsal Coalition Complicated by Interdigital Neuroma

Abstract

We present the case of a 20-year-old man with the chief complaint of right foot pain for the past three years presenting with focal bony prominence at dorsomedial aspect of right mid foot with interdigital pain. MRI demonstrated a metatarsal coalition with interdigital neuroma.

Distal metatarsal coalition: A rare case report

“…Tarsal coalition is the commonest, majority of which affects the calcaneonavicular and talocalcaneal joints [1] . Metatarsal coalition remains extremely rare [1–6] , with our case being the second documented case of coalition occurring at the level of distal metatarsal.…”

“…Perman and Wertheimer [7] classified coalition as congenital or acquired. Most reported cases are congenital coalition between the bases of fourth and fifth [1–3] ; or first and second metatarsal bones [4,5] . With only one other case in the literature [6] , our case adds to the literature the second case of 4th and 5th congenital distal metatarsal coalition.…”

Intermetatarsal Coalition: Case Report, Literature Review, and Imaging Findings of an Underrecognized and Underdiagnosed Cause of Foot Pain

“…These cases are predominantly diagnosed on plain radiographs. Only one case report had CT performed [ 3 ] and only a single separate case featured MRI, and this was only performed due to initial suspicion of the radiographic abnormality being secondary to an osteochondroma [ 8 ].…”

“…Symptoms typically present in adolescents, likely corresponding to the ossification process of coalition, lending to increased stress and microfractures [ 3 , 12 ]. Given the increased stress in metatarsal heads, bursal-neuroma complexes in intermetatarsal spaces can also complicate intermetatarsal base coalition [ 8 ] ( Figure 1(f) ).…”

“…Other potential soft tissue complications of coalition to assess for, apart from interdigital bursal-neuroma complexes as mentioned above, are plantar plate degeneration and metatarsal head oedema from the altered weight-bearing dynamics [ 8 ].…”