Is ultrasonography a reliable way to confirm the diagnosis of Morton's neuroma?

The diagnosis of Morton's neuroma is based on patient history and clinical findings. Occasionally, however, the diagnosis still remains in doubt despite careful examination. While magnetic resonance imaging (MRI) has been used to evaluate such cases, its specificity remains unproven and its availability is not universal. Ultrasonography may offer a reasonable alternative to MRI. Eight patients clinically diagnosed with neuromas who had not responded to conservative care underwent ultrasonography. Sonography in each demonstrated a round or oval echogenic mass where a neuroma was believed to be present. Sonography on a control group of 10 asymptomatic patients (20 feet) revealed no such mass. Pathologic inspections of surgically resected specimens confirmed the diagnosis of Morton's neuroma. With no false positive results, this preliminary study indicates ultrasonography may be a specific diagnostic test for Morton's neuroma.