Ultrasonography and magnetic resonance imaging in the diagnosis of Morton's neuroma.
BACKGROUND
Magnetic resonance imaging (MRI) and ultrasonography are used widely for the diagnosis of Morton's neuroma. The aim of this study was to assess the accuracy of these two modalities as diagnostic tools in Morton's neuroma.


METHODS
Fifty feet of 47 consecutive patients (39 women and 8 men; mean age, 46 years; age range, 36-64 years) who presented between January 1, 2005, and June 30, 2008, were included in the study. Twenty-five feet were investigated with ultrasonography and 25 with MRI. Morton's neuroma was confirmed surgically and histologically in all of the patients. A Student unpaired t test was applied.


RESULTS
Twenty-two MRIs were diagnostic (sensitivity, 88%). Three patients with negative MRI findings underwent ultrasonography and were found to have a neuroma smaller than 5 mm. Twenty-four ultrasound scans demonstrated the neuroma (sensitivity, 96%), with five neuromas being smaller than 5 mm.


CONCLUSIONS
Ultrasonography has a slightly higher sensitivity in the diagnosis of Morton's neuroma, particularly of neuromas smaller than 5 mm, and should be the preferred imaging modality in suspected cases, and MRI should be reserved for cases with equivocal diagnosis.
Department of Trauma and Orthopaedics, Chase Farm Hospital, Enfield, Middlesex, England. malifazal@hotmail.com
Muhammad Ali
MA
Fazal
Ishrat
I
Khan
Cherian
C
Thomas
D000328:Adult; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009463:Neuroma / Q000175:diagnosis* / Q000601:surgery; D010524:Peripheral Nervous System Neoplasms / Q000175:diagnosis* / Q000601:surgery; D012680:Sensitivity and Specificity; D014034:Toes; D014463:Ultrasonography