Department of Orthopedic Surgery, Korea University Guro Hospital, Seoul, South Korea.
Department of Orthopedic Surgery, Korea University Ansan Hospital, Ansan, South Korea.
J Ultrasound Med. 2019 Apr;38(4):1009-1014. doi: 10.1002/jum.14787. Epub 2018 Sep 23.
This study aims to evaluate the clinical importance of intermetatarsal distance, size of neuroma, and proportion of neuroma in the intermetatarsal space in examinations of Morton neuroma using ultrasonography.
Clinical prognosis was observed prospectively after corticosteroid injections in 136 patients with Morton neuroma, and the results were compared with ultrasonographic parameters of intermetatarsal distance, size of neuroma, and proportion of neuroma in the intermetatarsal space.
Twenty-one patients (15%) did not respond to corticosteroid injections and underwent surgical treatment for Morton neuroma. Logistic regression analysis and receiver operating characteristic curve analysis showed that the size of the neuroma was the sole predictor of failure of corticosteroid injections (P = .002). No other factors were significant for the prediction of clinical prognosis (P > .05).
The size of the neuroma on ultrasonography is the sole predictor of corticosteroid injection failure, while intermetatarsal distance and proportion of neuroma in the intermetatarsal space are not significant when predicting clinical prognosis of Morton neuroma.
本研究旨在评估超声检查中跖间距离、神经瘤大小和神经瘤在跖间空间中所占比例对莫顿神经瘤的临床重要性。
前瞻性观察 136 例莫顿神经瘤患者接受皮质类固醇注射后的临床预后，并将结果与跖间距离、神经瘤大小和神经瘤在跖间空间中所占比例的超声参数进行比较。
21 例（15%）患者对皮质类固醇注射无反应，行莫顿神经瘤手术治疗。Logistic 回归分析和受试者工作特征曲线分析显示，神经瘤大小是皮质类固醇注射失败的唯一预测因素（P = .002）。其他因素对临床预后的预测均无统计学意义（P > .05）。
超声检查中神经瘤的大小是皮质类固醇注射失败的唯一预测因素，而跖间距离和神经瘤在跖间空间中所占比例在预测莫顿神经瘤的临床预后时无显著意义。
