[Treatment of intermetatarsal neuromas with alcohol injection under US guide].
OBJECTIVE
The cause of intermetatarsal neuromas is unclear; the pathogenesis is, most likely, a mechanically induced degenerative neuropathy or an entrapment of the intermetatarsal nerve under the transverse intermetatarsal ligament. Treatment of intermetatarsal neuromas includes very simple methods, such as changing shoe styles, or more complex conservative treatments such as orthotic devices and steroid injections until surgical therapy. This study aimed to evaluate the neuroma's intralesional treatment with alcohol sclerosing injection as a viable alternative to steroid injections or surgery in persisting symptoms.


METHODS
23 patients with clinical symptoms of intermetatarsal neuroma and who had not undergone other treatments were treated with 30% alcohol applied under US guide. Each patient received from 3 to 7 applications at 7 to 10 day intervals.


RESULTS
We performed 3 applications in 17 patients, 5 in 5 patients and 7 in 1 patient for a total of 83 applications with a technical success of 100%. A complete resolution of all symptoms was achieved in 91% of the patients.


CONCLUSIONS
Alcohol sclerosing intralesional treatment under US guide is a viable alternative to conservative or surgery treatments in patients with intermetatarsal neuromas.
Masala
S
S
Dipartimento di Diagnostica per Immagini e Radiologia Interventistica, Università degli Studi Tor Vergata, Rome, Italy. salva.mazala@tiscalinet.it
Fanucci
E
E
Ronconi
P
P
Sodani
G
G
Taormina
P
P
Romagnoli
A
A
Simonetti
G
G
D000328:Adult; D000368:Aged; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D005534:Foot Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008684:Metatarsus; D008875:Middle Aged; D009437:Neuralgia / Q000150:complications / Q000209:etiology; D009463:Neuroma / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D015911:Sclerotherapy; D013997:Time Factors; D014463:Ultrasonography
D000431:Ethanol
Trattamento dei neuromi intermetatarsali con somministrzione intralesionale di alcol sotto guida US.