Intermetatarsal bursae are small bursae located in the web spaces of the forefoot between the metatarsal heads, positioned dorsal to the interdigital nerve and the deep transverse metatarsal ligament. They facilitate gliding between adjacent metatarsal heads during toe extension and push-off.
Intermetatarsal bursae can enlarge and contribute to symptoms in the same web space as Morton neuroma, making clinical and imaging distinction important since the two structures frequently coexist. Ultrasound can differentiate a hypoechoic bursal mass from a fusiform neural mass, and MRI shows characteristic signal on T2 sequences. Corticosteroid injection targets the bursa effectively. Surgical excision is occasionally required when conservative treatment fails.
Bursal inflammation in the web space produces forefoot burning pain and numbness similar to Morton neuroma, often aggravated by footwear and relieved by removing shoes, treated with wide-toed shoes, metatarsal pads, and corticosteroid injection.
Intermetatarsal bursitis and Morton neuroma frequently coexist in the same web space, creating a combined mass that may require both neuroma excision and bursectomy at the time of surgery for reliable symptom relief.
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