The Vulcan salute sign: a non-sensitive but specific sign for Morton’s neuroma on radiographs

Any good Vulcan will show you the Vulcan salute and wish you to “live long and prosper,” but folks suffering from Morton’s neuroma can do so only with annoying forefoot pain. A study carried out by Dr. Julien Galley and his team of radiologists at the University of Zurich found that “[t]he Vulcan salute sign on conventional radiographs is specific for Morton’s neuroma.” The study was published July 14, 2021, in the journal Skeletal Radiology.

Thomas Morton first described his namesake condition in 1876. His description located the pain in the fourth metatarsophalangeal articulation, but the most common location is “in the third interspace, followed by the second interspace,” according to Galley, et al. The divergence of the toes is likely due to the mass effect Morton’s neuroma may have, spreading the toes slightly, and leading to the characteristic V-sign. “The mass effect of Morton’s neuroma can lead to a divergence of the toes, which is visible on conventional radiographs. Therefore, radiographs may be helpful in diagnosing Morton’s neuroma,” concludes Galley and his team.

Galley, J., Sutter, R., Germann, C. et al. The Vulcan salute sign: a non-sensitive but specific sign for Morton’s neuroma on radiographs. Skeletal Radiol (2021). Accessed July 28, 2021. The article and accompanying image are published as Open Access under the Creative Commons Attribution 4.0 International License. Licensing information can be obtained at No modifications were made to the image or caption; minor editorial modifications were made to the quoted text to make it flow with the article text where necessary.

Fig. 2 Positive V-sign. A Fifty-two-year-old woman with positive 2/3 V-sign on radiograph (left). Coronal T1-weighted (up) and T2-weighted (down) spine-echo MR images demonstrate the presence of a typical T1/T2 hypointense Morton’s neuroma (orange arrow). B Forty-nine-year-old woman with positive 3/4 V-sign on conventional radiograph (left) and the corresponding MR images (right) showing Morton’s neuroma (orange arrow)