Mulder sign

Mulder sign is a clinical test used to examine causes of metatarsalgia associated with Morton neuroma. It has high specificity (100%) but relatively low sensitivity (62%) . See the ultrasound correlate described separately: sonographic Mulder sign.

Technique

With one hand, clasp the metatarsal heads between the thumb and fingers or thenar eminence and fingers. Place the thumb of the other hand on the plantar surface of the foot in the intermetatarsal space at the site of the suspected neuroma. Squeeze the metatarsal heads together with one hand and concomitantly exert pressure on the interdigital space with the thumb of the other hand.

You may feel a mass displace towards the plantar surface of the foot as you squeeze the metatarsal heads together. The mass may be compressed between the metatarsal heads before it is displaced which is associated with the characteristic pain and coinciding with a palpable click as the lesion escapes the intermetatarsal space .

History and etymology

The eponymous Mulder sign was first described by Dutch orthopedic surgeon Jacob D Mulder in 1951 .