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COMPARATIVE STUDY
JOURNAL ARTICLE
Morton's neuroma: A clinical versus radiological diagnosis.
Foot and Ankle Surgery : Official Journal of the European Society of Foot and Ankle Surgeons 2012 March
BACKGROUND: The aim of our study was to compare the clinical versus radiological diagnosis of patients suffering from a Morton's neuroma.
METHODS: Clinical assessments and pre-operative radiological imaging of patients who had excision of a Morton's neuromas were retrospectively compared.
RESULTS: 43 neuromas were excised from 36 patients over 68 months. The commonest clinical symptoms were tenderness on direct palpation (100%), pain on weight bearing (91%) which was relieved by rest (81%). The most sensitive clinical sign was a Mulder's click. Clinical assessment had a sensitivity of 98% (42/43). Ultrasonography had a sensitivity of 90% (28/31) and magnetic resonance imaging had a sensitivity of 88% (14/16).
CONCLUSION: There is no absolute requirement for imaging patients who clinically have a Morton's neuroma. The two main indications for imaging are (a) an unclear clinical assessment and (b) cases when more than one web space is affected. Ultrasonography should be the investigation of choice.
METHODS: Clinical assessments and pre-operative radiological imaging of patients who had excision of a Morton's neuromas were retrospectively compared.
RESULTS: 43 neuromas were excised from 36 patients over 68 months. The commonest clinical symptoms were tenderness on direct palpation (100%), pain on weight bearing (91%) which was relieved by rest (81%). The most sensitive clinical sign was a Mulder's click. Clinical assessment had a sensitivity of 98% (42/43). Ultrasonography had a sensitivity of 90% (28/31) and magnetic resonance imaging had a sensitivity of 88% (14/16).
CONCLUSION: There is no absolute requirement for imaging patients who clinically have a Morton's neuroma. The two main indications for imaging are (a) an unclear clinical assessment and (b) cases when more than one web space is affected. Ultrasonography should be the investigation of choice.
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