Mulder's sign

Last updated
Mulder's sign
Differential diagnosis Morton's neuroma

Mulder's Sign is a physical exam finding associated with Morton's neuroma, which may be elicited while the patient is in the supine position on the examination table. The pain of the neuroma, as well as a click, can be produced by squeezing the two metatarsal heads together with one hand, while concomitantly putting pressure on the interdigital space with the other hand. With this technique, the pain of the Morton's neuroma will be localized strictly to the plantar surface of the involved interspace, with paresthesias radiating into the affected toes.

Eponym

It is named after the Dutch Surgeon & Podiatrist, Jacob D. Mulder (19011965). [1] [2] [3]

Footnotes

  1. Mulder, Jacob D.; "The causative mechanism in Morton's metatarsalgia", Journal of Bone and Joint Surgery 1951, 33B (British volume), pp. 94-95
  2. Bencardino, Jenny; Rosenberg, Zehava S.; Beltran, Javier; Liu, Xiang; and Marty-Delfaut, Emmanuelle; "Morton's Neuroma: Is It Always Symptomatic?" American Journal of Roentgenology, September 2000, vol. 175, no. 3, pp. 649-653
  3. "The Mulder Test for Morton Neuroma" Archived 2006-11-01 at the Wayback Machine , in Waldman, Steven; Physical Diagnosis of Pain, Saunders, October 2005, p. 381, ISBN   1-4160-0112-3

Related Research Articles

Arthritis Type of joint disorder

Arthritis is a term often used to mean any disorder that affects joints. Symptoms generally include joint pain and stiffness. Other symptoms may include redness, warmth, swelling, and decreased range of motion of the affected joints. In some types of arthritis, other organs are also affected. Onset can be gradual or sudden.

Debeaking Trimming of a birds beak, usually performed on domesticated birds

Debeaking, beak trimming, or beak conditioning is the partial removal of the beak of poultry, especially layer hens and turkeys although it may also be performed on quail and ducks. Most commonly, the beak is shortened permanently, although regrowth can occur. The trimmed lower beak is somewhat longer than the upper beak. A similar but separate practice, usually performed by an avian veterinarian or an experienced birdkeeper, involves clipping, filing or sanding the beaks of captive birds for health purposes – in order to correct or temporarily alleviate overgrowths or deformities and better allow the bird to go about its normal feeding and preening activities. Amongst raptor keepers, this practice is commonly known as "coping".

Toe Digit of a foot

Toes are the digits (fingers) of the foot of a tetrapod. Animal species such as cats that walk on their toes are described as being digitigrade. Humans, and other animals that walk on the soles of their feet, are described as being plantigrade; unguligrade animals are those that walk on hooves at the tips of their toes.

Phantom limb The sensation that an amputated or missing limb is attached

A phantom limb is the sensation that an amputated or missing limb is still attached. Approximately 80 to 100% of individuals with an amputation experience sensations in their amputated limb. However, only a small percentage will experience painful phantom limb sensation. These sensations are relatively common in amputees and usually resolve within two to three years without treatment. Research continues to explore the underlying mechanisms of phantom limb pain (PLP) and effective treatment options.

<i>The X-Files</i> (season 2) Season of television series The X-Files

The second season of the science fiction television series The X-Files commenced airing on the Fox network in the United States on September 16, 1994, concluded on the same channel on May 19, 1995, after airing all 25 episodes. The series follows Federal Bureau of Investigation special agents Fox Mulder and Dana Scully, portrayed by David Duchovny and Gillian Anderson respectively, who investigate paranormal or supernatural cases, known as X-Files by the FBI.

Vestibular schwannoma Medical condition

A vestibular schwannoma (VS), also called acoustic neuroma, is a benign tumor that develops on the vestibulocochlear nerve that passes from the inner ear to the brain. The tumor originates when Schwann cells that form the insulating myelin sheath on the nerve malfunction. Normally, Schwann cells function beneficially to protect the nerves which transmit balance and sound information to the brain. However, sometimes a mutation in the tumor suppressor gene, NF2, located on chromosome 22, results in abnormal production of the cell protein named Merlin, and Schwann cells multiply to form a tumor. The tumor originates mostly on the vestibular division of the nerve rather than the cochlear division, but hearing as well as balance will be affected as the tumor enlarges.

Tinels sign Medical condition

Tinel's sign is a way to detect irritated nerves. It is performed by lightly tapping (percussing) over the nerve to elicit a sensation of tingling or "pins and needles" in the distribution of the nerve. Percussion is usually performed moving distal to proximal. It is named after Jules Tinel.

Electrotherapy

Electrotherapy is the use of electrical energy as a medical treatment. In medicine, the term electrotherapy can apply to a variety of treatments, including the use of electrical devices such as deep brain stimulators for neurological disease. The term has also been applied specifically to the use of electric current to speed wound healing. Additionally, the term "electrotherapy" or "electromagnetic therapy" has also been applied to a range of alternative medical devices and treatments.

Neuralgia is pain in the distribution of a nerve or nerves, as in intercostal neuralgia, trigeminal neuralgia, and glossopharyngeal neuralgia.

Phantom pain is a perception that an individual experiences relating to a limb or an organ that is not physically part of the body. Limb loss is a result of either removal by amputation or congenital limb deficiency. However, phantom limb sensations can also occur following nerve avulsion or spinal cord injury.

Metatarsalgia, literally metatarsal pain and colloquially known as a stone bruise, is any painful foot condition affecting the metatarsal region of the foot. This is a common problem that can affect the joints and bones of the metatarsals.

Nerve block

Nerve block or regional nerve blockade is any deliberate interruption of signals traveling along a nerve, often for the purpose of pain relief. Local anesthetic nerve block is a short-term block, usually lasting hours or days, involving the injection of an anesthetic, a corticosteroid, and other agents onto or near a nerve. Neurolytic block, the deliberate temporary degeneration of nerve fibers through the application of chemicals, heat, or freezing, produces a block that may persist for weeks, months, or indefinitely. Neurectomy, the cutting through or removal of a nerve or a section of a nerve, usually produces a permanent block. Because neurectomy of a sensory nerve is often followed, months later, by the emergence of new, more intense pain, sensory nerve neurectomy is rarely performed.

Neuroma Nervous system benign neoplasm that is characterized as a nerve tissue tumor

A neuroma is a growth or tumor of nerve tissue. Neuromas tend to be benign ; many nerve tumors, including those that are commonly malignant, are nowadays referred to by other terms.

Mortons neuroma Benign neuroma of an intermetatarsal plantar nerve

Morton's neuroma is a benign neuroma of an intermetatarsal plantar nerve, most commonly of the second and third intermetatarsal spaces, which results in the entrapment of the affected nerve. The main symptoms are pain and/or numbness, sometimes relieved by ceasing to wear footwear with tight toe boxes and high heels. The condition is named after Thomas George Morton, though it was first correctly described by a chiropodist named Durlacher.

Radiofrequency ablation Surgical procedure

Radiofrequency ablation (RFA), also called fulguration, is a medical procedure in which part of the electrical conduction system of the heart, tumor or other dysfunctional tissue is ablated using the heat generated from medium frequency alternating current. RFA is generally conducted in the outpatient setting, using either local anesthetics or conscious sedation anesthesia. When it is delivered via catheter, it is called radiofrequency catheter ablation.

Mortons toe Medical condition

Morton's toe is the condition of having a first metatarsal which is short in relation to the second metatarsal. It is a type of brachymetatarsia.

The transverse metatarsal ligament is a narrow band which runs across and connects together the heads of all the metatarsal bones. It is blended anteriorly with the plantar (glenoid) ligaments of the metatarsophalangeal articulations.

Dorsal digital nerves of foot Various nerve branches that supply the toes

Dorsal digital nerves of foot are branches of the intermediate dorsal cutaneous nerve, medial dorsal cutaneous nerve, sural nerve and deep fibular nerve.

Multiple endocrine neoplasia type 2B Medical condition

Multiple endocrine neoplasia type 2B is a genetic disease that causes multiple tumors on the mouth, eyes, and endocrine glands. It is the most severe type of multiple endocrine neoplasia, differentiated by the presence of benign oral and submucosal tumors in addition to endocrine malignancies. It was first described by Wagenmann in 1922, and was first recognized as a syndrome in 1965-1966 by E.D. Williams and D.J. Pollock.

A neurolytic block is a form of nerve block involving the deliberate injury of a nerve by freezing or heating ("neurotomy") or the application of chemicals ("neurolysis"). These interventions cause degeneration of the nerve's fibers and temporary interference with the transmission of nerve signals. In these procedures, the thin protective layer around the nerve fiber, the basal lamina, is preserved so that, as a damaged fiber regrows, it travels within its basal lamina tube and connects with the correct loose end, and function may be restored. Surgical cutting of a nerve (neurectomy), severs these basal lamina tubes, and without them to channel the regrowing fibers to their lost connections, over time a painful neuroma or deafferentation pain may develop. This is why the neurolytic is usually preferred over the surgical block.