Ultrasound guided alcohol ablation of Morton's neuroma.
BACKGROUND
Morton's neuroma is a common cause of metatarsalgia. This study evaluated the efficacy of ultrasound guided alcohol injection as a treatment for this condition.


METHODS
Data from 87 treatment courses were included in this study with a mean follow of 14.3 months.


RESULTS
Technical success was 100%. One patient developed symptoms consistent with an allergic reaction to the injection and one patient declined further injection because of periprocedural pain. Partial or total treatment response was achieved in 66%, with 32% of patients having complete resolution of pain. The median visual analogue score (VAS) decreased from 8 pre-procedure to 4 post-procedure (p < 0.0001). Procedural success was greater in patients under 55 years old and in those with solitary neuromas. Seventeen patients (20%) went on to have surgery due to continuing pain.


CONCLUSIONS
Ultrasound guided alcohol ablation for the treatment of Morton's neuroma was a safe procedure that significantly reduced pain and may offer an alternative therapy to surgery.
Nuffield Orthopaedic Centre, Windmill Rd, Headington, Oxford OX3 7HE, United Kingdom. rachelmusson@hotmail.co.uk
Rachel E
RE
Musson
Jasdev S
JS
Sawhney
Leslie
L
Lamb
Antony
A
Wilkinson
Haron
H
Obaid
D055011:Ablation Techniques; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D005545:Forefoot, Human / Q000294:innervation; D006801:Humans; D015552:Injections, Intralesional / Q000379:methods; D008297:Male; D008875:Middle Aged; D009463:Neuroma / Q000000981:diagnostic imaging / Q000628:therapy*; D010147:Pain Measurement; D010524:Peripheral Nervous System Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy*; D018084:Ultrasonography, Interventional; D055815:Young Adult
D000431:Ethanol