Contribution of a new electrophysiologic test to Morton's neuroma diagnosis

Pardal-Fernández, José Manuel; Palazón-García, Elena; Fernández, Francisco Sousa; Cabo, Carlos de

doi:10.1016/j.fas.2013.12.006

Cited by 4 publications

(3 citation statements)

References 27 publications

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“…It is well known that the diagnostic accuracy of ultrasonography (56%) regarding Morton’s neuroma is inferior compared with MRI (83%) or electroneurography (sensitivity 82%-93%, specificity 80%-85%). 25,34 Also, different electroneurographic methods are available to localize a Morton’s neuroma. 2,25 Therefore, a combination of MRI, fluoroscopy, and electroneurography—as used in this study—should enhance the localization.…”

Section: Discussionmentioning

confidence: 99%

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Improved Injection Technique of Ethanol for Morton’s Neuroma

et al. 2020

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Background: Morton’s neuroma is a common cause of forefoot pain. Various conservative methods (injections of various pharmacologic agents) have been published with an outcome of 6%-75% success rate (free of pain in daily life) per injection. The aim of the present study was to assess the outcome of an improved localization technique, a higher dosage, and a higher percentage of ethanol. Methods: Using fluoroscopic and electroneurographic guidance, 2.5 mL of 70% ethanol were injected into 33 feet with a magnetic resonance imaging (MRI)–verified neuroma. We evaluated patients at up to 5-year follow-up. Results: A “success rate” of more than 82% per single injection (defined as free of pain in daily life) was achieved and no recurrence was seen over 5 years. All scores (visual analog scale; Short Form–36 subscales, American Orthopaedic Foot & Ankle Society ankle-hindfoot score) showed significant improvement ( P < .0001). Mean 1.2 injections were necessary. No significant side effects were seen. However, some mild pain persisted in some patients who participated in sports. Conclusion: The injection of 2.5 mL of 70% ethanol under fluoroscopic and electroneurographic guidance was a safe method for the treatment of MRI-verified Morton’s neuromas. Combining the effect of a higher percentage of alcohol and a higher dosage and an improved localization technique resulted in a high rate of patients without pain. Level of Evidence: Level IV, cases series, prospective.

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Section: Discussionmentioning

confidence: 99%

“…25,34 Also, different electroneurographic methods are available to localize a Morton's neuroma. 2,25 Therefore, a combination of MRI, fluoroscopy, and electroneurography-as used in this study-should enhance the localization. Nevertheless, MRI remains an expensive diagnostic tool, with limited access in some areas compared with sonography.…”

Section: Discussionmentioning

confidence: 99%

Improved Injection Technique of Ethanol for Morton’s Neuroma

et al. 2020

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“…75 A higher sensitivity reaching 90% was reported performing the same NCS while using subdermal electrodes. 76…”

Section: Electrophysiological Studiesmentioning

confidence: 99%

Common Entrapment Neuropathies

Malek

Salameh

2019

Semin Neurol

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Entrapment neuropathies are defined as compression of peripheral nerves due to known or unknown causes. The high incidence and variety of presentations require a comprehensive knowledge of these conditions, especially in neurology and orthopedic surgery clinical practices. Detailed knowledge of topographic anatomy, clinical manifestations, and appropriate use of electrophysiological studies with selective addition of neuromuscular ultrasonography are needed to establish an early and accurate diagnosis to advice patients and provide them with a comprehensive treatment plan. In this article, we discuss the most common forms of entrapment neuropathies in the upper and lower extremities.

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