Sindhoora Murthy, MD

TFCC PERIPHERAL ULNAR INSERTION ON US. Lately, I’ve been trying to achieve an assessment of the ulnar peripheral insertion of the TFCC, trying to find a way to do it. I share an anatomical demonstration video by ultrasound of the ulnar peripheral insertion of the TFCC. Fairly well demonstrated the regional anatomy. In the following days, I will share a video demonstrating the US technique (I don’t know if someone else has thought of the same thing previously, I haven’t seen anything similar in the literature). And also a video with the pathological version of peripheral insertion. #mskrad #MedTwitter

Morton's neuroma occurs at the terminal bifurcation of the common plantar digital nerve. The deep transverse metatarsal ligament connects the metatarsals. Below the ligament, we find the nerve, and above the ligament, the bursa. And distal to the anterior free edge of the ligament, the neuroma. It is at this level that the nerve makes a pronounced dorsal turn at the distal free edge of the ligament. We can see this demonstrated in the video/illustration. This explains one of the theories; entrapment between the plantar soft tissues and the ligament. The dorsal approach for me is the best 👍 . We avoid the thick plantar skin. Compressing with the finger on the plantar side and sliding it also lets us differentiate the distinct components, where the ligament remains immobile. We can also mobilize the nerve and see how it imprints against the anterior free edge of the ligament, understanding the pathomechanism. Finally, the Mulder maneuver always helps. #mskrad