Unifying Concepts

Diagnostic Criteria for Symptomatic Neuroma

After nerve injury, disorganized or incomplete nerve regeneration may result in a neuroma. The true incidence of symptomatic neuroma is unknown, and the diagnosis has traditionally been made based on patient history, symptoms, physical examination, and the anatomic location of pain, along with response to diagnostic injection.

Diagnostic Criteria for Symptomatic Neuroma

To receive a diagnosis of symptomatic neuroma, patients must have

  1. Pain with at least 3 qualifying “neuropathic” characteristics,
  2. Symptoms in a defined neural anatomic distribution, and
  3. A history of a nerve injury or suspected nerve injury.

In addition, patients must have at least 2 of the following 4 findings:

  1. Positive Tinel sign on examination at/along suspected nerve injury site,
  2. Tenderness/pain on examination at/along suspected nerve injury site,
  3. Positive response to a diagnostic local anesthetic injection, and
  4. Ultrasound or magnetic resonance imaging confirmation of neuroma.



  1. Arnold DMJ, Wilkens SC, Coert JH, Chen NC, Ducic I, Eberlin KR. Diagnostic Criteria for Symptomatic Neuroma. Ann Plast Surg. 2019 Apr;82(4):420-427. [Medline]
  2. Hwang K. Surgery for Symptomatic Neuroma: Anatomic Distribution and Predictors of Secondary Surgery. Plast Reconstr Surg. 2020 Mar;145(3):662e-663e. [Medline]


Created Dec 21, 2022.

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