Department of Geriatrics, Neurosciences and Orthopaedics, Catholic University of the Sacred Heart, Rome, Italy.
Neuroriabilitazione ad Alta Intensità, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Foot Ankle Int. 2020 Dec;41(12):1474-1479. doi: 10.1177/1071100720946748. Epub 2020 Aug 28.
Morton's neuroma (MN) is often a diagnostic dilemma lacking a gold standard set of diagnostic criteria. Advanced imaging of MN is evolving including ultrasonography. The current study aimed to analyze the relationship between ultrasonographic findings and symptoms, clinical data, and operative findings in a subgroup of patients.
We evaluated physical examination, ultrasonographic findings, symptoms, and in a subgroup, the operative findings for Morton's neuroma. We analyzed the symptoms, the findings on physical examination, and ultrasonography data and performed a statistical correlation between them. A total of 175 patients were seen for suspected Morton's neuroma during the last 7 years.
Neuropathic pain of the toes was reported in 63% of patients. Presence of ultrasonographic findings suggesting Morton's neuroma was observed in 77% of cases. A mild significant relationship between neuropathic pain and positive ultrasonographic findings was observed. We found a strong correlation between ultrasonographic and clinical evaluation, but more than half with clinical negative Morton's neuroma had positive findings at ultrasonography. In the subgroup of operatively treated patients (n = 44) surgery confirmed Morton's neuroma in all patients who had positive ultrasonography findings.
The current study suggests that the association of ultrasonographic evaluation and clinical evaluation can be very useful for the management of Morton's neuroma. Our study could help with the development of a multiperspective approach in the diagnosis of Morton's neuroma.
Level II, prospective cohort survey study.
莫顿氏神经瘤（MN）通常是一个缺乏金标准诊断标准的诊断难题。MN 的高级影像学检查正在发展，包括超声检查。本研究旨在分析一组患者的超声表现与症状、临床数据和手术结果之间的关系。
我们评估了体格检查、超声检查结果、症状，以及在亚组中，莫顿氏神经瘤的手术结果。我们分析了症状、体格检查和超声检查数据，并对它们之间进行了统计学相关性分析。在过去的 7 年中，共有 175 名疑似莫顿氏神经瘤的患者接受了检查。
63%的患者报告有脚趾神经性疼痛。77%的病例观察到提示莫顿氏神经瘤的超声检查结果。神经性疼痛与阳性超声检查结果之间存在轻度显著相关性。我们发现超声检查和临床评估之间存在很强的相关性，但在临床阴性莫顿氏神经瘤的患者中，超过一半的患者在超声检查中有阳性发现。在手术治疗的患者亚组（n=44）中，所有超声检查结果阳性的患者均手术证实为莫顿氏神经瘤。
本研究表明，超声评估与临床评估的结合对莫顿氏神经瘤的治疗非常有用。我们的研究可以帮助发展一种多视角的莫顿氏神经瘤诊断方法。
II 级，前瞻性队列研究。
