Treatment of intermetatarsal Morton's neuroma with alcohol injection under US guide: 10-month follow-up

Morton's neuroma (MN) is a frequent cause of metatarsalgia. The aim of our study was to evaluate the efficacy of neuroma alcohol-sclerosing therapy (NAST) under US guide in MN after a 10-month follow-up. Forty intermetatarsal neuromas underwent alcohol-sclerosing therapy after sonographic evalu...

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Bibliographic Details
Published in:European radiology 2004-03, Vol.14 (3), p.514-518
Main Authors: Fanucci, Ezio, Masala, Salvatore, Fabiano, Sebastiano, Perugia, Dario, Squillaci, Ettore, Varrucciu, Viviana, Simonetti, Giovanni
Format: Article
Language:English
Subjects:
Adult
Aged
Ethanol - administration & dosage
Female
Follow-Up Studies
Foot Diseases - diagnostic imaging
Foot Diseases - therapy
Humans
Injections, Intralesional - methods
Male
Metatarsal Bones
Middle Aged
Neuroma - diagnostic imaging
Neuroma - therapy
Sclerotherapy
Time Factors
Ultrasonography
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Summary:Morton's neuroma (MN) is a frequent cause of metatarsalgia. The aim of our study was to evaluate the efficacy of neuroma alcohol-sclerosing therapy (NAST) under US guide in MN after a 10-month follow-up. Forty intermetatarsal neuromas underwent alcohol-sclerosing therapy after sonographic evaluation of their dimensions and echotexture. After subcutaneous anesthesia, a sclerosing solution composed of anesthetic (carbocaine-adrenaline 70%) and ethylic alcohol (30%) was injected inside the mass under US guidance. The procedure was repeated at intervals of 15 days until the resolution of the symptoms. A total or partial symptomatic relief was obtained in 36 cases (90%). No procedure-related complications were observed. Transitory plantar pain, due to the flogistic reaction induced by the sclerosing solution, occurred in 6 cases (15%). The 10-month follow-up revealed a 20-30% mass volume reduction and an adiposus-like change in echotexture. In the 4 cases (10%) of therapeutic failure, the preliminary sonography demonstrated a hypoechoic echotexture with a strong US beam attenuation corresponding to a highly fibrous neuroma after surgical resection. The NAST is a feasible and cost-efficient procedure with high rates of therapeutic success.
ISSN:0938-7994
1432-1084
DOI:10.1007/s00330-003-2057-7