Treatment of intermetatarsal Morton's neuroma with alcohol injection under US guide: 10-month follow-up.
Morton's neuroma (MN) is a frequent cause of metatarsalgia. The aim of our study was to evaluate the efficacy of neuroma alcohol-sclerosing therapy (NAST) under US guide in MN after a 10-month follow-up. Forty intermetatarsal neuromas underwent alcohol-sclerosing therapy after sonographic evaluation of their dimensions and echotexture. After subcutaneous anesthesia, a sclerosing solution composed of anesthetic (carbocaine-adrenaline 70%) and ethylic alcohol (30%) was injected inside the mass under US guidance. The procedure was repeated at intervals of 15 days until the resolution of the symptoms. A total or partial symptomatic relief was obtained in 36 cases (90%). No procedure-related complications were observed. Transitory plantar pain, due to the flogistic reaction induced by the sclerosing solution, occurred in 6 cases (15%). The 10-month follow-up revealed a 20-30% mass volume reduction and an adiposus-like change in echotexture. In the 4 cases (10%) of therapeutic failure, the preliminary sonography demonstrated a hypoechoic echotexture with a strong US beam attenuation corresponding to a highly fibrous neuroma after surgical resection. The NAST is a feasible and cost-efficient procedure with high rates of therapeutic success.
Fanucci
Ezio
E
Department of Diagnostic Imaging and Interventional Radiology, University of Rome Tor Vergata, Viale Oxford 81, 00133 Rome, Italy. sebas575@yahoo.it
Masala
Salvatore
S
Fabiano
Sebastiano
S
Perugia
Dario
D
Squillaci
Ettore
E
Varrucciu
Viviana
V
Simonetti
Giovanni
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 / Q000379:methods; D008297:Male; D008682:Metatarsal Bones; D008875:Middle Aged; D009463:Neuroma / Q000000981:diagnostic imaging / Q000628:therapy*; D015911:Sclerotherapy; D013997:Time Factors; D014463:Ultrasonography
D000431:Ethanol