Abstract:
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Purpose: To describe the procedure and clinical outcomes of ultrasound-guided Morton¢s neuroma injections.
Methods and Materials: All ultrasound-guided neuroma injections from our ultrasound database were reviewed. Clinical outcomes questionnaires and a 7 day pain log were distributed to patients. This abstract reports our earliest collected data (N=16 neuromas); a minimum number of 50 clinical responses is ultimately expected.
Results: Hypoechoic neuromas were clearly visualized with sonography and were distinguishable from other causes of forefoot pain, such as metatarsophalangeal joint synovitis and intermetatarsal bursae. Neuromas were injected with an anesthetic/steroid mixture using sonographic guidance from a longitudinal approach, either from the dorsal or plantar surface, depending on the size of the neuroma. The echogenic linear needle tip was visualized entering the hypoechoic neuroma in all cases. The sizes of the neuromas injected ranged between 5 and 16mms. Average pain level pre-injection was 7 áscale of 1 áno painñ to 10 ásevere painññ and average pain level was 3 at 7 days post-injection. Sixty-three percent of the neuromas injected exhibited a 50-78% decrease in pain level at one-week status post single injection; this is greater than published reports in the orthopaedic literature, where only a 50% partial response is reported after a one to three week series of non-image guided injections.
Conclusion: Ultrasound can be used to accurately target Morton¢s neuromas and therefore appropriately direct therapeutic interventions.
Sofka MD, C,
Ultrasound-guided Interdigital Neuroma Injections: Procedure and Clinical Outcomes. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3105132.html
