Assesses for the presence of metatarsal foot pain.

  • Morton’s Test
  • Morton’s Neuroma Test
  • Mulder Click Test
  • Mulder’s Test

  • Foot pain
  • intermetatarsal mass

Patient Position
  • Seated or supine, with the extremity of interest in a non-weight-bearing position
Examiner Position
  • Seated or crouched near the patient’s lower extremity of interest
Steps of Performance
  1. Examiner palpates the medial and lateral aspects of the metatarsal heads
  2. Using one hand to form a “pincer” grip, the examiner applies a forceful squeeze around the forefoot, compressing the metatarsal heads together
Alternative Methods
  • Examiner may passively dorsiflex the patient’s foot prior to applying pressure to the metatarsal region
  • Examiner’s contralateral hand may be used to apply additional pressure to the sole of the foot near the site of a suspected Morton’s neuroma

Compression of the forefoot at the metatarsal heads  irritates numerous structures including the metatarsal bones themselves, as well as the intermetatarsal plantar digital nerve as it passes inferiorly to the metatarsal ligament.

General

Positives

Aggravation or reproduction of foot pain

  • Intermetatarsal/digital (Morton’s) neuroma
  • Metatarsal fracture
  • Generalized metatarsalgia

Audible click (Mulder's Sign)

  • Intermetatarsal/digital neuroma

Pertinent Negatives

DATA
TAGS
References
Mahadevan D, Venkatesan M, Bhatt R, Bhatia M. Diagnostic Accuracy of Clinical Tests for Morton's Neuroma Compared With Ultrasonography. J Foot Ankle Surg. 2015;54(4):549-553. doi:10.1053/j.jfas.2014.09.021
Hattam P, Smeatham A. Special Tests in Musculoskeletal Examination. Edinburgh: Churchill Livingstone, 2010.
Bhatia M, Thomson L. Morton's neuroma - Current concepts review. J Clin Orthop Trauma. 2020;11(3):406-409. doi:10.1016/j.jcot.2020.03.024
Placzek, J.D., Boyce, D.A., 2006. Orthopaedic Physical Therapy Secrets, second ed. Elsevier Health Sciences, Missouri.

Assesses for the presence of metatarsal foot pain.

  • Foot pain
  • intermetatarsal mass

Patient Position
  • Seated or supine, with the extremity of interest in a non-weight-bearing position
Examiner Position
  • Seated or crouched near the patient’s lower extremity of interest
Steps of Performance
  1. Examiner palpates the medial and lateral aspects of the metatarsal heads
  2. Using one hand to form a “pincer” grip, the examiner applies a forceful squeeze around the forefoot, compressing the metatarsal heads together
Alternative Methods
  • Examiner may passively dorsiflex the patient’s foot prior to applying pressure to the metatarsal region
  • Examiner’s contralateral hand may be used to apply additional pressure to the sole of the foot near the site of a suspected Morton’s neuroma

Compression of the forefoot at the metatarsal heads  irritates numerous structures including the metatarsal bones themselves, as well as the intermetatarsal plantar digital nerve as it passes inferiorly to the metatarsal ligament.

General

Positives

Aggravation or reproduction of foot pain

  • Intermetatarsal/digital (Morton’s) neuroma
  • Metatarsal fracture
  • Generalized metatarsalgia

Audible click (Mulder's Sign)

  • Intermetatarsal/digital neuroma

Pertinent Negatives