Intermetatarsal bursitis

Intermetatarsal bursitis is a common cause of metatarsalgia and is frequently associated with Morton neuromas and plantar plate tears.

Clinical presentation

Symptoms include forefoot pain, feeling of walking a lump, swelling and/or tingling .

Pathology

Etiology

• trauma
• infection
• rheumatoid arthritis
• gout

Radiographic features

Fluid collections between the metatarsal heads; fluid collections <3 mm may be physiological .

Ultrasound

• hypoechoic, compressible soft tissue structure in the webspace
• hyperemia may be present on color Doppler

MRI

MRI signal characteristics

• T1: low signal
• T2: high signal
• T1C+: thin peripheral enhancement

Differential diagnosis

• physiological fluid in the intermetatarsal bursa should be considered if <3 mm
• Morton neuroma
  • non-compressible solid mass on ultrasound
  • enhancing mass on MRI
  • often occurs in association with intermetatarsal bursitis

See also

• bursitis