Is the thumb index finger 'squeeze test' the most accurate clinical test for diagnosing a Morton's neuroma?
In a paper by Mahadevan et al. the authors found that simply squeezing between the toes at the site of the location of the neuroma was the most accurate test. However, the strongest correlation was found between Mulder's sign and larger neuromas, as appreciated on ultrasound.
The London Podiatry Centre would agree that the squeeze test and Mulder's test are the most useful clinical indicators for diagnosing a Morton's neuroma. In fact, Morton's neuromas can sometimes be appreciated on ultrasound in the absence of symptoms and these clinical tests are therefore an important part in establishing the diagnosis. Whilst the squeeze test is relatively straightforward, Mulder's sign does require some skill on the part of the practitioner. Although the squeeze test can be helpful, Mr McCulloch believes that the Mulder's sign is the most reliable test because it is highly specific for Morton's neuroma whilst the squeeze test could indicate other forms of pathology.