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Interdigital (Morton) neuroma: high-resolution MR imaging with a solenoid coil
S J Erickson1, P B Canale, G F Carrera
1Department of Radiology, Medical College of Wisconsin, Milwaukee 53226.
Abstract:
Fifteen patients (17 feet) with symptoms suggestive of plantar interdigital neuroma underwent magnetic resonance (MR) imaging at 1.5 T with a solenoid forefoot coil with an 8-cm field of view. Surgery was subsequently performed on six feet. Fifteen interdigital masses were identified with MR imaging. Five of these, in feet that underwent surgery, were pathologically confirmed neuromas. In the remaining foot that underwent surgery, flexor tendon injury with probable inflammatory reaction was demonstrated with MR imaging but was interpreted as indeterminate for neuroma. No neuronal was identified at surgery, which otherwise confirmed the MR imaging findings. Neuromas were most conspicuous on T1-weighted images as foci of decreased signal intensity well demarcated from adjacent fat tissue. The lesions were poorly seen on T2-weighted images, where they appeared isointense or slightly hypointense to fat tissue in all cases. Prominent regions of increased signal intensity, presumably representing fluid in intermetatarsal bursae, were seen proximal to 10 of the 15 masses found with MR imaging.
Insights
Magnetic resonance (MR) imaging accurately identified interdigital masses in patients with plantar interdigital neuroma symptoms. MR imaging findings correlated well with surgical and pathological results, aiding diagnosis.
Area of Science:
- Radiology
- Orthopedic Surgery
- Pathology
Background:
- Plantar interdigital neuroma is a common cause of forefoot pain.
- Accurate diagnosis is crucial for effective treatment planning.
- Magnetic resonance (MR) imaging offers detailed visualization of soft tissues.
Purpose of the Study:
- To evaluate the diagnostic accuracy of 1.5 T MR imaging for plantar interdigital neuroma.
- To correlate MR imaging findings with surgical and pathological outcomes.
Main Methods:
- Fifteen patients with suspected plantar interdigital neuroma underwent 1.5 T MR imaging.
- A solenoid forefoot coil with an 8-cm field of view was utilized.
- Surgical correlation was performed in six feet.
Main Results:
- MR imaging identified fifteen interdigital masses.
- Five surgically confirmed neuromas showed decreased signal intensity on T1-weighted images.
- Fluid in intermetatarsal bursae was noted proximal to 10 masses.
Conclusions:
- 1.5 T MR imaging is effective in detecting interdigital masses suggestive of neuroma.
- MR imaging findings correlate well with surgical and pathological diagnoses.
- T1-weighted imaging is superior for visualizing neuromas, while T2-weighted imaging is less sensitive.