Document Detail


Morton neuroma: MR imaging after resection--postoperative MR and histologic findings in asymptomatic and symptomatic intermetatarsal spaces.
MedLine Citation:
PMID:  20501722     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate the prevalence of postoperative magnetic resonance (MR) imaging findings in asymptomatic and symptomatic patients after resection of Morton neuroma. MATERIALS AND METHODS: This study was approved by the institutional review board. Informed consent was obtained from each participant. Fifty-eight consecutive patients (46 women, 12 men) who had undergone resection of a painful Morton neuroma (90 Morton neuromas were removed in 66 feet), pre- and postoperative MR imaging, and clinical follow-up for a minimum of 2 years after surgery were identified. Two experienced musculoskeletal radiologists evaluated MR images with regard to the presence of presumed recurrent Morton neuroma, scar, or intermetatarsal bursitis. The prevalence of abnormalities in asymptomatic and symptomatic intermetatarsal spaces was determined. The results of the second radiologist were used only to determine interobserver reliability. The kappa statistics were obtained to assess interobserver agreement. Seven patients with presumed recurrent Morton neuroma underwent repeat surgery. RESULTS: Clinically speaking, 68 intermetatarsal spaces (44 of 58 patients [76%], 47 feet) were asymptomatic at follow-up and 22 (14 of 58 patients [24%], 19 feet) were symptomatic. A presumed Morton neuroma was found in 18 (26%) of the asymptomatic spaces and 11 (50%) of the symptomatic spaces. A presumed scar was found in six (9%) of the asymptomatic spaces and two (9%) of the symptomatic spaces. A presumed intermetatarsal bursitis was found in six (9%) of the asymptomatic spaces and six (27%) of the symptomatic spaces. Interobserver agreement for presumed recurrent Morton neuroma was substantial (kappa = 0.64). Histologic examination of presumed recurrent Morton neuroma revealed fibrous tissue but no sign of peripheral neural tissue. CONCLUSION: MR imaging after Morton neuroma resection commonly reveals Morton neuroma-like abnormalities in asymptomatic and symptomatic intermetatarsal spaces.
Authors:
Norman Espinosa; Juergen Wilfried Schmitt; Nadja Saupe; Gerardo Juan Maquieira; Beata Bode; Patrick Vienne; Marco Zanetti
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Radiology     Volume:  255     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-26     Completed Date:  2010-07-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  850-6     Citation Subset:  AIM; IM    
Copyright Information:
Copyright RSNA, 2010
Affiliation:
Department of Orthopedics, University Hospital Balgrist, University of Zurich, Forchstrasse 340, CH-8008 Zurich, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Female
Foot Diseases / pathology*,  surgery
Humans
Magnetic Resonance Imaging / methods*
Male
Middle Aged
Neuroma / pathology*,  surgery
Peripheral Nervous System Neoplasms / pathology*,  surgery
Statistics, Nonparametric
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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