Common in runners and people wearing high heeled shoes
It's mechanically induced neuropathic degeneration.
Symptoms:
Pain and burning between 3rd and 4th toes
Examination:
Tenderness on palpation between 3rd and 4 th toes on the plantar surface
Mulder sign: Clicking sensation when palpating between 3rd and 4th toes with simultaneous squeezing of the metatarsal joints.
Diagnosed clinically
Treatment: Conservatively ( b/l padded shoe inserts)
Failed conservative treatment requires surgery.
