Which physical findings are diagnostic of interdigital neuritis?

Updated: Oct 15, 2019
  • Author: Minoo Hadjari Hollis, MD; Chief Editor: Thomas M DeBerardino, MD  more...
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Answer

The Mulder click is a useful diagnostic test for interdigital neuritis. The forefoot is held in one hand, and the metatarsal heads are squeezed while the other hand places direct pressure on the plantar aspect of the interspace. As the metatarsal heads are compressed, the enlarged nerve is pushed plantar and away from the metatarsal heads, and a click is palpated with the digit in the plantar web space just distal to the transverse intermetatarsal ligament.

This test is often uncomfortable for the patients but does not usually reproduce their symptoms. The palpated mass can be pushed up again in the interspace with manual pressure while partial compression is maintained on the metatarsal heads. Many times, one digit is observed to move suddenly.


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