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Morton's neuroma: A clinical versus radiological diagnosis
Philip Pastides1, Sameh El-Sallakh, Charalambos Charalambides
1The Whittington Hospital, Magdala Avenue, London N19 5NF, United Kingdom. ppastides@hotmail.com
Background:
The aim of our study was to compare the clinical versus radiological diagnosis of patients suffering from a Morton's neuroma.
Methods:
Clinical assessments and pre-operative radiological imaging of patients who had excision of a Morton's neuromas were retrospectively compared.
Results:
43 neuromas were excised from 36 patients over 68 months. The commonest clinical symptoms were tenderness on direct palpation (100%), pain on weight bearing (91%) which was relieved by rest (81%). The most sensitive clinical sign was a Mulder's click. Clinical assessment had a sensitivity of 98% (42/43). Ultrasonography had a sensitivity of 90% (28/31) and magnetic resonance imaging had a sensitivity of 88% (14/16).
Conclusion:
There is no absolute requirement for imaging patients who clinically have a Morton's neuroma. The two main indications for imaging are (a) an unclear clinical assessment and (b) cases when more than one web space is affected. Ultrasonography should be the investigation of choice.
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