Department of Radiology, Nuffield Orthopaedic Centre, Oxford University Hospital NHS Trust, Oxford, UK.
Department of Radiology, Nuffield Orthopaedic Centre, Oxford University Hospital NHS Trust, Oxford, UK.
Clin Radiol. 2021 Mar;76(3):235.e15-235.e23. doi: 10.1016/j.crad.2020.10.006. Epub 2020 Nov 7.
Morton's neuroma is a commonly encountered cause of forefoot pain, which may limit weight-bearing activities and footwear choices. Although the aetiology and pathomechanism of this condition is controversial, the histological endpoint is well established as benign perineural fibrosis of a common plantar digital nerve, typically within the third intermetatarsal space. The diagnosis of Morton's neuroma is mainly based on characteristic symptoms and clinical findings, but may be confirmed by ultrasonography. Although ultrasound is a highly accurate diagnostic tool for Morton's neuroma, it is subject to interoperator variability due to differences in technique and level of experience. In this paper, the authors review the anatomy of the common plantar digital nerves and surrounding structures in the forefoot, which are deemed relevant to the understanding of Morton's neuroma, especially from a sonographic point of view. Several theories of the pathomechanism of Morton's neuroma are briefly discussed. The main purpose of this article is to illustrate the ultrasound techniques for evaluating Morton's neuroma and performing ultrasound-guided corticosteroid injections.
Morton 神经瘤是引起前足疼痛的常见原因，可能会限制负重活动和鞋类选择。尽管这种情况的病因和发病机制存在争议，但该疾病的组织学终点是明确的，即常见足底趾神经的良性神经周围纤维化，通常位于第三跖骨间空间内。Morton 神经瘤的诊断主要基于特征性症状和临床发现，但可通过超声检查确认。尽管超声检查是诊断 Morton 神经瘤的高度准确工具，但由于技术和经验水平的差异，它受到操作者间变异性的影响。本文作者回顾了前足常见足底趾神经及其周围结构的解剖结构，这些结构与理解 Morton 神经瘤有关，特别是从超声的角度来看。简要讨论了 Morton 神经瘤发病机制的几种理论。本文的主要目的是说明评估 Morton 神经瘤和进行超声引导下皮质类固醇注射的超声技术。
