Morton's neuroma: Clinical testing and imaging in 76 feet, compared to a control group

2011 ◽  
Vol 17 (3) ◽  
pp. 197-200 ◽  
Author(s):  
R. Owens ◽  
N. Gougoulias ◽  
H. Guthrie ◽  
A. Sakellariou
Keyword(s):  
Control Group ◽  
Clinical Testing ◽  
Morton’S Neuroma ◽  
Morton's Neuroma

Radiographic Analysis of Feet With and Without Morton’s Neuroma

2016 ◽  
Vol 38 (3) ◽  
pp. 310-317 ◽  
Author(s):  
Reza Naraghi ◽  
Alexandra Bremner ◽  
Linda Slack-Smith ◽  
Alan Bryant
Keyword(s):  
Control Group ◽  
Morton’S Neuroma ◽  
Level Of Evidence ◽  
Intermetatarsal Angle ◽  
Control Subjects ◽  
Radiographic Measurements ◽  
Valgus Angle ◽  
Angular Measurements ◽  
Morton's Neuroma ◽  
And Control

Background: The aim of this research was to investigate the association of various structural measurements of the forefoot with Morton’s neuroma (MN). Methods: Weightbearing anteroposterior and lateral foot radiographs of subjects attending the University of Western Australia (UWA) Podiatry Clinic and the first author’s private practice were included in this study. A single assessor measured the following angles: lateral intermetatarsal angle (LIMA), intermetatarsal angle (IMA), hallux valgus angle (HVA), digital divergence between the second and third digits (DD23), digital divergence between the third and fourth digits (DD34) and relative metatarsal lengths of the first to fifth metatarsals (Met1-5), and the effect of MN size as measured by ultrasonograph on digital divergence. Intratester reliability of all radiographic measurements was assessed on all radiographic measurements. The study included 101 subjects, of whom 69 were diagnosed with MN and 32 were control subjects without MN. The mean (± standard deviation) age of MN subjects was 52 (±15) years and for control subjects, 48 (±12) years. Results: When comparing all feet, there were no significant differences in the LIMA, HVA, IMA, digital divergence angles and the relative metatarsal distances between subjects with MN and control subjects. No relationship between MN size and digital divergence was found in either foot, or in either neuroma location. Conclusion: We were unable to demonstrate any relationship in this study between radiographic metatarsal length and angular measurements in a symptomatic MN group compared to a control group. In addition, we did not find any correlation between the size of MN as measured from ultrasonographic images and radiographic evidence of digital divergence. Level of Evidence: Level III, case control study.

scholarly journals Corticosteroid Injection for the Treatment of Morton’s Neuroma: A Prospective, Double-Blinded, Randomized, Placebo-Controlled Trial

2017 ◽  
Vol 38 (9) ◽  
pp. 944-951 ◽  
Author(s):  
Xavier Lizano-Díez ◽  
Alberto Ginés-Cespedosa ◽  
Eduard Alentorn-Geli ◽  
Daniel Pérez-Prieto ◽  
Gemma González-Lucena ◽  
...  
Keyword(s):  
Local Anesthetic ◽  
Corticosteroid Injection ◽  
Controlled Trial ◽  
Case Series ◽  
Control Group ◽  
Placebo Control ◽  
Morton’S Neuroma ◽  
Level Of Evidence ◽  
Morton's Neuroma ◽  
And Function

Background: The effectiveness of corticosteroid injection for the treatment of Morton’s neuroma is unclear. In addition, most of the studies related to it are case-control or retrospective case series. The purpose of this study was to compare the effectiveness between corticosteroid injection associated with local anesthetic and local anesthetic alone (placebo control group) for the treatment of Morton’s neuroma. Methods: Forty-one patients with a diagnosis of Morton’s neuroma were randomized to receive 3 injections of either a corticosteroid plus a local anesthetic or a local anesthetic alone. The patients and the researcher who collected data were blinded to the treatment groups. The visual analog scale for pain and the American Orthopaedic Foot & Ankle Score (metatarsophalangeal/interphalangeal score) were obtained at baseline, after each injection, and at 3 and 6 months after the last injection. Results: There were no significant between-group differences in terms of pain and function improvement at 3 and 6 months after treatment completion in comparison with baseline values. At the end of the study, 17 (48.5%) patients requested surgical excision of the neuroma: 7 (44%) in the experimental group and 10 (53%) in the control group ( P = 1.0). Conclusion: The injection of a corticosteroid plus a local anesthetic was not superior to a local anesthetic alone in terms of pain and function improvement in patients with Morton’s neuroma. Level of Evidence: Level I, randomized controlled trial.

Effectiveness of customized insoles in patients with Morton’s neuroma: a randomized, controlled, double-blind clinical trial

2019 ◽  
Vol 33 (12) ◽  
pp. 1898-1907 ◽  
Author(s):  
Hilda Alcântara Veiga de Oliveira ◽  
Jamil Natour ◽  
Mariana Vassalli ◽  
Andre Rosenfeld ◽  
Fabio Jennings ◽  
...  
Keyword(s):  
Control Group ◽  
Morton’S Neuroma ◽  
Double Blind ◽  
Foot Health ◽  
Randomized Controlled ◽  
Sf 36 ◽  
Foot Function ◽  
Morton's Neuroma ◽  
Arch Support ◽  
Foot Health Status Questionnaire

Objective: To assess the effectiveness of customized insole in patients with Morton’s neuroma. Design: Double-blind randomized controlled trial with intent-to-treat analysis. Setting: Outpatients, University Hospital. Subjects: A total of 72 patients with Morton’s neuroma met the inclusion criteria and were randomly allocated to either the study group ( n = 36) or the control group ( n = 36). Interventions: The study group was assigned to use a customized insole with metatarsal and arch support made of ethyl vinyl acetate and the control group received a flat insole of the same material, color, and density. Main measures: The primary outcome measure was walking pain intensity measured by the visual analogue scale. The secondary outcomes were as follows: pain at rest, palpation, and paresthesia (visual analogue scale); functional disability (6-minute walk test, Foot Function Index, and Foot Health Status Questionnaire); quality of life (Health Survey Short Form-36 (SF-36)); and foot pressure (AM Cube FootWalk Pro program). Results: In the comparison between the groups over time, a statistically significant difference, with improvement in favor of the experimental group, was found for pain during walking ( P = 0.048); in the general health domains ( P < 0.001) and physical activity ( P = 0.025) of the Foot Health Status Questionnaire; in the general Foot Function Index score ( P = 0.012); and in the functional capacity domain of the SF-36 questionnaire ( P = 0.046). For the other parameters, no difference was found between groups. Conclusion: The study demonstrated that customized insole with metatarsal and arch support relieved walking pain and improved patient-reported measures of function in patients with Morton’s neuroma.

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

2021 ◽  
Author(s):  
Julien Galley ◽  
Reto Sutter ◽  
Christoph Germann ◽  
Christian W. A. Pfirrmann
Keyword(s):  
Interobserver Reliability ◽  
Weight Bearing ◽  
Intraclass Correlation ◽  
Control Group ◽  
Study Group ◽  
Morton’S Neuroma ◽  
Retrospective Case ◽  
Intermetatarsal Angle ◽  
Significant Difference ◽  
Morton's Neuroma

Abstract Objectives To assess the value of the divergence of toes on conventional radiographs of the foot for diagnosing Morton’s neuroma. Methods This retrospective case–control study was approved by the local ethics committee. In 100 patients with MRI-proven Morton’s neuroma 2/3 or 3/4 (study group) and 100 patients without (control group), conventional weight-bearing dorso-plantar view radiographs were evaluated for the subjective presence of interphalangeal divergence, called the Vulcan salute sign or V-sign, by two blinded, independent musculoskeletal radiologists. Interphalangeal angles (2/3 and 3/4) and intermetatarsal angle I/V were measured. The t test and chi-squared test were used to compare the groups. Diagnostic performance was calculated. Interobserver reliability was assessed using κ statistics and intraclass correlation coefficient (ICC). Results The difference between the groups was significant (P < 0.05) regarding the presence of the V-sign, which was found in 30 of 100 patients with Morton neuroma and in 3 of 100 control patients, with a sensitivity of 30% and a specificity of 97%. The differences between interphalangeal angles were significant (P < 0.05) between the groups. The interphalangeal angle 2/3 mean values were 7.9° (± 4.8) for the study group vs 5.4° (± 2.6) for the controls; the 3/4 angle values were 6.5° (± 3.8) and 3.4° (± 2.5), respectively. There was no significant difference between the groups in the intermetatarsal angle I/V. Interobserver agreement was substantial for the V-sign, with a κ value of 0.78. The ICC was excellent concerning angle measurements, with all values ≥ 0.94. Conclusion The Vulcan salute sign on conventional radiographs is specific for Morton’s neuroma.

Effectiveness of Ultrasound-Guided Corticosteroid Injection in the Treatment of Morton's Neuroma

2008 ◽  
Vol 29 (5) ◽  
pp. 483-487 ◽  
Author(s):  
Maja Markovic ◽  
Ken Crichton ◽  
John W. Read ◽  
Peter Lam ◽  
Henry Kim Slater
Keyword(s):  
Corticosteroid Injection ◽  
Ultrasound Guided ◽  
Morton’S Neuroma ◽  
Morton's Neuroma

Minimally invasive neurectomy for Morton’s neuroma with Interdigital approach. Long term results

The Foot ◽  
2021 ◽  
pp. 101808
Author(s):  
Héctor José Masaragian ◽  
Fernando Perin ◽  
Leonel Rega ◽  
Nicolas Ameriso ◽  
Luciano Mizdraji ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Long Term Results ◽  
Morton’S Neuroma ◽  
Morton's Neuroma

scholarly journals Patient Related Outcome Measures (PROMs) in Morton’s Neuroma: Conservative vs. Surgical Management at One-Year Follow-Up

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0002
Author(s):  
Alastair Faulkner ◽  
Alistair Mayne ◽  
Fraser Harrold
Keyword(s):  
Outcome Measures ◽  
Surgical Management ◽  
Conservative Management ◽  
Morton’S Neuroma ◽  
Significant Difference ◽  
Morton's Neuroma ◽  
One Year ◽  
Patient Related Outcome ◽  
Eq Vas

Category: Midfoot/Forefoot Introduction/Purpose: Morton’s neuroma is a common condition affecting the foot and is associated with chronic pain and disability. Conservative management including a combination of orthotic input; injection or physiotherapy, and surgical excision are current treatment options. There is a paucity of literature regarding patient related outcome measures (PROMs) data in patients managed conservatively. We sought to compare conservative with surgical management of Morton’s neuroma using PROMs data in patients with follow-up to one year. Methods: Prospective data collection commenced from April 2016. Patients included had to have a confirmed Morton’s neuroma on ultrasound scan. Patient demographics including age, sex and BMI were collected. The primary outcome measures were the Manchester Foot Score for pain (MOX-FQ), EQ time trade off (TTO) and EQ visual analogue scale (VAS) taken pre-operatively; at 26-weeks and at 52-weeks post-operatively. Results: 194 patients were included overall: 79 patients were conservatively managed and 115 surgically managed. 19 patients were converted from conservative to surgical management. MOX-FQ pain scores: pre-op conservative 52.15, surgical 61.56 (p=0.009), 6-months conservative 25.1, surgical 25.39 (p=0.810), 12 months conservative 18.54, surgical 20.52 (p=0.482) EQ-TTO scores: pre-op conservative 0.47, surgical 0.51 (p=0.814), 6-months conservative 0.41, surgical 0.49 (p=0.261), 12 months conservative 0.26, surgical 0.37 (p=0.047) EQ-VAS scores: pre-op conservative 63.84, surgical 71.03 (p=0.172), 6-months conservative 46.10, surgical 52.51 (p=0.337), 12 months conservative 30.77, surgical 37.58 (p=0.227) Satisfaction at 12 months: conservative 17 (21.5%), surgical 32 (27.8%) p=0.327 Conclusion: This is one of the first studies investigating long-term PROMs specifically in conservative management for Morton’s neuroma patients. There was no significant difference in pain score and EQ-VAS between all conservative treatments and surgical management at 12 months There was no significant difference in satisfaction at 12 months between conservative and surgical groups.

Multiple neuromas coexisting with rheumatoid synovitis and a rheumatoid nodule

2000 ◽  
Vol 90 (5) ◽  
pp. 252-255 ◽  
Author(s):  
LA Zielaskowski ◽  
SJ Kruljac ◽  
JJ DiStazio ◽  
S Bastacky
Keyword(s):  
Rare Case ◽  
Relevant Literature ◽  
Rheumatoid Nodule ◽  
Morton’S Neuroma ◽  
Forefoot Pain ◽  
Rheumatoid Nodules ◽  
Morton's Neuroma ◽  
The Many

The authors present a rare case of multiple intermetatarsal neuromas coexisting with rheumatoid synovitis and a rheumatoid nodule. A brief review of rheumatoid nodules as a source of forefoot pain and a review of the relevant literature are provided. A rheumatoid nodule is just one of the many diagnoses that must be considered when one encounters pedal symptoms similar to those associated with Morton's neuroma.

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