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Ultrasonography and Magnetic Resonance Imaging in the Diagnosis of Morton’s Neuroma

Muhammad Ali Fazal Department of Trauma and Orthopaedics, Chase Farm Hospital, Enfield, Middlesex, England

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 MBBS, FRCS (Eng), FRCS (Orth)
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Ishrat Khan Department of Trauma and Orthopaedics, Chase Farm Hospital, Enfield, Middlesex, England

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Cherian Thomas Department of Radiology, Chase Farm Hospital, Enfield, London, England

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Background:

Magnetic resonance imaging (MRI) and ultrasonography are used widely for the diagnosis of Morton’s neuroma. The aim of this study was to assess the accuracy of these two modalities as diagnostic tools in Morton’s neuroma.

Methods:

Fifty feet of 47 consecutive patients (39 women and 8 men; mean age, 46 years; age range, 36–64 years) who presented between January 1, 2005, and June 30, 2008, were included in the study. Twenty-five feet were investigated with ultrasonography and 25 with MRI. Morton’s neuroma was confirmed surgically and histologically in all of the patients. A Student unpaired t test was applied.

Results:

Twenty-two MRIs were diagnostic (sensitivity, 88%). Three patients with negative MRI findings underwent ultrasonography and were found to have a neuroma smaller than 5 mm. Twenty-four ultrasound scans demonstrated the neuroma (sensitivity, 96%), with five neuromas being smaller than 5 mm.

Conclusions:

Ultrasonography has a slightly higher sensitivity in the diagnosis of Morton’s neuroma, particularly of neuromas smaller than 5 mm, and should be the preferred imaging modality in suspected cases, and MRI should be reserved for cases with equivocal diagnosis. (J Am Podiatr Med Assoc 102(3): 184–186, 2012)

Corresponding author: Muhammad Ali Fazal, MBBS, FRCS (Eng), FRCS (Orth), Department of Trauma & Orthopaedics, Chase Farm Hospital, The Ridgeway, Enfield, Middlesex, EN2 8JL, England. (E-mail: malifazal@hotmail.com)