Morton Neuroma: Evaluated with Ultrasonography and MR Imaging

Department of Diagnostic Radiology and the Research Institute of Radiological Science, Yonsei University College of Medicine, Seodaeumun-Gu, Seoul, Korea.
Korean Journal of Radiology (Impact Factor: 1.57). 04/2007; 8(2):148-55. DOI: 10.3348/kjr.2007.8.2.148
Source: PubMed


The purpose of this study was to compare the diagnostic accuracy of both ultrasonography (US) and magnetic resonance imaging (MRI) for the assessment of Morton neuroma.
Our study group was comprised of 20 neuromas from 17 patients, and the neuromas were confirmed on surgery following evaluation with US, MRI, or both US and MRI. The diagnostic criterion for Morton neuroma, as examined by US, was the presence of a round or ovoid, well-defined, hypoechoic mass. The diagnostic criterion, based on MR imaging, was a well defined mass with intermediate to low signal intensity on both the T1- and T2-weighted images. The retrospective comparison between the sonographic and MR images was done by two experienced radiologists working in consensus with the surgical and pathologic correlations.
The detection rate of Morton neuroma was 79% for 14 neuromas from 11 patients who had undergone US followed by an operation. The detection rate was 76% for 17 neuromas from 15 patients who had undergone MRI and a subsequent operation. The mean size of the examined neuromas was 4.9 mm on the US images and it was 5.1 mm on the MRI studies. Ten neuromas (71%) were 5 mm or less as measured by US, and three neuromas were not detected, whereas on the MRI analysis, 10 neuromas (59%) were 5 mm or less and four neuromas were not visualized. Among the patients examined during postoperative follow-up, symptoms were completely relieved in 85% and the symptoms were partially relieved in 15%.
US and MR imaging are comparable modalities with high detection rate for the evaluation of Morton neuroma.

Download full-text


Available from: Mi-Jung Lee,
  • Source
    • "Nevertheless, some authors such as [14] estimated a higher than 91% sensitivity, close to 100% specificity, 100% positive predictive value and 20% negative predictive value for HRUS in MN. Other authors cite even higher sensitivity and specificity values for HRUS [5] [15] [16]. Our experience with the use of HRUS does not confirm such an optimistic outcome and perhaps certain caution is advisable. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Morton's neuroma causes metatarsalgia due to the interdigital neuropathy. The small nerve diameter compromises their evaluation in image studies. To overcome this problem we propose a new electrophysiological test. We conducted a prospective case-control study performing a orthodromic electroneurography using subdermal electrodes in controls and patients to assess the validity. Additionally all patients were tested with magnetic resonance. Some patients required surgery and subsequent histological evaluation. The new ENG procedure showed higher sensitivity and specificity. Methodological standardization was easy and the test was well tolerated by the subjects. Our test demonstrated remarkable diagnostic efficiency, and also was able to identify symptomatic patients undetected by magnetic resonance, which underlines the lack of correlation between the size and intensity of the lesion. This new electrophysiological method appears to be a highly sensitivity, well-tolerated, simple and low-cost for Morton's neuroma diagnosis.
    Foot and Ankle Surgery 06/2014; 20(2):109-14. DOI:10.1016/j.fas.2013.12.006
    • "MRI typically demonstrates a small lesion with intermediate signal intensity on T1-weighted images and low signal intensity on T2-weighted images. Moreover, image techniques are useful in assessing the location and size of neuromas as well as the presence of double lesions.1214 "
    [Show abstract] [Hide abstract]
    ABSTRACT: The diagnosis of Morton's neuroma is based primarily on clinical findings. Ultrasonography (US) and magnetic resonance image (MRI) studies are considered complementary diagnostic techniques. The aim of this study was to establish the correlation and sensitivity of both techniques used to diagnose Morton's neuroma. Thirty seven patients (43 intermetatarsal spaces) with Morton's neuroma operated were retrospectively reviewed. In all cases MRI or ultrasound was performed to complement clinical diagnosis of Morton's neuroma. In all cases, a histopathological examination confirmed the diagnosis. Estimates of sensitivity were made and correlation (kappa statistics) was assessed for both techniques. Twenty seven women and 10 men participated with a mean age of 60 years. Double lesions presented in six patients. The second intermetatarsal space was affected in 10 patients and the third in 33 patients. An MRI was performed in 41 cases and a US in 23 cases. In 21 patients, both an MRI and a US were performed. With regard to the 41 MRIs performed, 34 were positive for Morton's neuroma and 7 were negative. MRI sensitivity was 82.9% [95% confidence interval (CI): 0.679-0.929]. Thirteen out of 23 US performed were positive and 10 US were negative. US sensitivity was 56.5% (95% CI: 0.345-0.768). Relative to the 21 patients on whom both techniques were carried out, the agreement between both techniques was poor (kappa statistics 0.31). Although ancillary studies may be required to confirm the clinical diagnosis in some cases, they are probably not necessary for the diagnosis of Morton's neuroma. MRI had a higher sensitivity than US and should be considered the technique of choice in those cases. However, a negative result does not exclude the diagnosis (false negative 17%).
    Indian Journal of Orthopaedics 05/2012; 46(3):321-5. DOI:10.4103/0019-5413.96390 · 0.64 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: A wireless sensor-network system has been developed that achieves a compact and flexible sensing node. Allocating most of the sensing-control block to a remote host enables miniaturization of a node, which contains necessary minimum function blocks. The sensor configuration is determined by the host to meet system needs and sent to a node as a command with a radio-frequency transmitter. The bit rate is high enough to send sensing data and receive commands. The prototype of a node occupies 22.5 cm<sup>3</sup> and consumes 150 mW the active mode and operates with a 2 MHz bit rate using a 315 MHz carrier frequency.
    Sensors, 2003. Proceedings of IEEE; 11/2003
Show more