Central Nervous System
A 34 – yrs-old woman runner presents with pain in the plantar portion of her foot between the third and fourth metatarsal bones. Which of the following is the most likely cause of her foot pain? (AIPG 2012)
a. Peripheral nerve trauma may result in specific symptoms and pathologic changes at specific sites.
b. Transection of a peripheral nerve may result in the formation of a traumatic neuroma if the axonal sprouts grow into scar tissue at the end of the proximal stump.
c. Sometimes peripheral nerves maybe compressed (entrapment neuropathy) due to repeated trauma.
d. Carpal tunnel syndrome is the most common entrapment neuropathy and results from compression of the medial nerve within the wrist by the transverse carpal ligament.
e. Symptoms include numbness and paresthesias of the tips of the thumb and second and third digits.
f. Another type of compression neuropathy is associated with a painful swelling of the plantar digital nerve between the second and third or the third and fourth metatarsal bones.
g. This lesion, called a Morton’s neuroma, is most often found in females.