title: Neuromas as the cause of pain in the residual limbs of amputees. An ultrasound study.
abstract: OBJECTIVE
  To explore the morphology of neuromas and to determine the differences, if any, between asymptomatic and symptomatic neuromas using ultrasound.
  
  
  METHODS
  Eighty patients with symptomatic neuromas were included in this retrospective review. High-resolution ultrasound examination was performed. Transducer pressure allowed real-time analysis of both symptomatic and asymptomatic neuromas. Quantifiable assessment of pain by the patient assigned a pain score of 0, 1, 2, or 3, to each neuroma.
  
  
  RESULTS
  One hundred and fifty-nine neuromas were identified in total. Fifty-three neuromas were asymptomatic (pain score=0), very severe pain was recorded in 54 (pain score=3), 16 neuromas were mildly painful (pain score=1) and 36 were moderately painful (pain score=2). The average number of neuromas per patient was 1.98, and the average number of symptomatic neuromas per patient was 1.3. There was no correlation between pain score and patient age, neuroma volume, amputation type, and time since amputation.
  
  
  CONCLUSIONS
  High-resolution ultrasound can distinguish between asymptomatic and symptomatic neuromas. Patient age, time since amputation, the type of amputation, and the neuroma volume were not related to the presence of pain.
authors.affiliation: Roehampton and Kingston Hospitals, Surrey, UK. Electronic address: oreillymarian@hotmail.com.
authors.forename: M A R
authors.initials: MAR
authors.lastname: O'Reilly
authors.affiliation: Clochan Barra Naofa, Western Road, Cork, Ireland.
authors.forename: P M R
authors.initials: PMR
authors.lastname: O'Reilly
authors.affiliation: Mathematics Department, University College Galway, Galway, Ireland.
authors.forename: J N
authors.initials: JN
authors.lastname: Sheahan
authors.affiliation: Douglas Bader Unit, Queen Mary's Hospital, Roehampton, Surrey and Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK.
authors.forename: J
authors.initials: J
authors.lastname: Sullivan
authors.affiliation: Clochan Barra Naofa, Western Road, Cork, Ireland.
authors.forename: H M
authors.initials: HM
authors.lastname: O'Reilly
authors.affiliation: Clochan Barra Naofa, Western Road, Cork, Ireland.
authors.forename: M J
authors.initials: MJ
authors.lastname: O'Reilly
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000674:Amputees; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009463:Neuroma / Q000150:complications* / Q000000981:diagnostic imaging*; D010146:Pain / Q000209:etiology*; D012189:Retrospective Studies; D014463:Ultrasonography / Q000379:methods*; D055815:Young Adult