title: Ultrasound Evaluation of Morton Neuroma Before and After Laser Therapy.
abstract: OBJECTIVE
  The objective of our study was to retrospectively assess for differences in imaging appearances of Morton neuromas before and after laser therapy using diagnostic ultrasound (US).
  
  
  METHODS
  A retrospective review was performed to identify patients who underwent US imaging to evaluate for Morton neuroma during the study period (June 1, 2013-July 1, 2014); of the 42 patients identified, 21 underwent US evaluations before and after laser therapy. US reports and images were reviewed and correlated with clinical history. The final study group consisted of 21 patients who had a total of 31 Morton neuromas evaluated using US after treatment. A retrospective review was then performed to characterize the appearances of these lesions before and after therapy followed by an analysis of variables.
  
  
  RESULTS
  Retrospective US review of 31 pretreatment Morton neuromas showed fusiform, heterogeneously hypoechoic masses with well-defined borders in most cases and that pain was reported when transducer pressure was applied in 97% (30/31) of cases. After treatment, lesions showed ill-defined borders (23/31), and pain with application of transducer pressure was either significantly decreased or absent (29/31); these findings were concordant with the clinical findings. Both of these characteristics were statistically significant (p < 0.0001). In addition, more Morton neuromas occurred in the second intermetatarsal space than in the third intermetatarsal space (p < 0.0001).
  
  
  CONCLUSIONS
  US may be used to identify posttreatment changes after laser therapy of Morton neuromas. Posttreatment changes include ill-defined borders and less pain or the absence of pain with the application of transducer pressure. These criteria may be applied in future clinical studies evaluating the efficacy of laser therapy for Morton neuroma.
authors.affiliation: 1 Department of Medical Imaging, University of Arizona Health Sciences Center, 1501 N Campbell Ave, Tucson, AZ 85724.
authors.forename: Lana H
authors.initials: LH
authors.lastname: Gimber
authors.affiliation: 1 Department of Medical Imaging, University of Arizona Health Sciences Center, 1501 N Campbell Ave, Tucson, AZ 85724.
authors.forename: David M
authors.initials: DM
authors.lastname: Melville
authors.affiliation: 2 Department of Surgery, University of Arizona Health Sciences Center, Tucon, AZ.
authors.forename: Darin A
authors.initials: DA
authors.lastname: Bocian
authors.affiliation: 3 Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Krupinski
authors.affiliation: 1 Department of Medical Imaging, University of Arizona Health Sciences Center, 1501 N Campbell Ave, Tucson, AZ 85724.
authors.forename: Matthew P Del
authors.initials: MP
authors.lastname: Guidice
authors.affiliation: 1 Department of Medical Imaging, University of Arizona Health Sciences Center, 1501 N Campbell Ave, Tucson, AZ 85724.
authors.forename: Mihra S
authors.initials: MS
authors.lastname: Taljanovic
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D000070607:Morton Neuroma / Q000000981:diagnostic imaging* / Q000628:therapy*; D011300:Preoperative Care; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014463:Ultrasonography / Q000379:methods*
keywords: Morton neuroma; laser therapy; metatarsalgia; ultrasound