Morton Neuroma: MR Imaging in Prone, Supine, and Upright Weight-bearing Body Positions

Weishaupt, Dominik; Treiber, Karl; Kundert, Hans-Peter; Zollinger, Hans Ulrich; Vienne, Patrice; Hodler, Juerg; Willmann, Jürgen K.; Marinček, Borut; Zanetti, M.

doi:10.1148/radiol.2263011925

Cited by 81 publications

(49 citation statements)

References 14 publications

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“…Operated neuromas ranged from 7 to 13 mm. This agrees with literature (15) , which describes that neuromas smaller than 5 mm do not provide good neurectomy outcomes. Thus, the accurate surgical indication was crucial for the results achieved.…”

Section: Case Series and Methodssupporting

confidence: 92%

Estudo retrospectivo do tratamento cirúrgico do neuroma de morton por via plantar

Barbosa¹,

Tiradentes²,

Ignácio³

et al. 2005

Acta ortop. bras.

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Com o propósito de avaliar a eficácia da técnica cirúrgica - neurectomia por via plantar -, em portadores de neuroma de Morton, 19 pacientes foram submetidos a esse tratamento. Portanto, foram 19 neuromas, sendo 84,3% do sexo feminino, 15,7% do sexo masculino; 31,5% no segundo espaço intermetatarsal, 68,5% no terceiro; 47,3% no lado direito e 52,7% no esquerdo. A cirurgia foi realizada por via plantar em todos os casos, com tempo médio de acompanhamento de 9 meses, e o resultado foi considerado satisfatório em 89,5% dos pacientes. O tempo de retorno às atividades foi de 6 semanas em 84,2%. Dois pacientes se apresentaram insatisfeitos, ambos devido à dor residual abaixo da cicatriz. Os autores concluem que, a neurectomia por via plantar foi satisfatória, pois há uma melhor exposição do neuroma, boa cicatrização, retorno rápido às atividades e melhora da dor.

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Section: Case Series and Methodssupporting

confidence: 92%

Estudo retrospectivo do tratamento cirúrgico do neuroma de morton por via plantar

Barbosa¹,

Tiradentes²,

Ignácio³

et al. 2005

Acta ortop. bras.

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“…When changing to the weightbearing position, the majority of the neurovascular bundles were located above this line. In a recent study, we demonstrated that Morton neuromas move from plantar to dorsal when they are investigated in weightbearing position instead of non-weight-bearing position (28). Together with the herein reported data in asymptomatic volunteers, it may be concluded that entrapment of the nerve in the intermetatarsal space and compression of the nerve against the transverse metatarsal ligament represents an important biomechanical factor in the pathogenesis of Morton neuroma.…”

Section: Discussionsupporting

confidence: 68%

MR imaging of the forefoot under weight‐bearing conditions: Position‐related changes of the neurovascular bundles and the metatarsal heads in asymptomatic volunteers

Weishaupt¹,

Treiber²,

Jacob³

et al. 2002

Magnetic Resonance Imaging

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Purpose:To assess practicability of weight-bearing magnetic resonance (MR) imaging of the forefoot, and to demonstrate position-related changes of the neurovascular bundles and the metatarsal heads in asymptomatic volunteers. Materials and Methods:With an open-configuration MR system, 32 feet of 32 asymptomatic individuals aged 20 -60 years were studied in supine and weight-bearing body positions. Transverse T1-weighted spin-echo MR images were performed. MR images were evaluated qualitatively with regard to image quality, visibility, and position-dependent changes of the neurovascular bundle. In addition, the position of the metatarsal heads was analyzed quantitatively.Results: Weight-bearing MR imaging was feasible in all 32 feet. Quality of MR images obtained in the weightbearing position was superior to that obtained in the supine position (P Ͻ 0.05). A change in the position of the neurovascular bundle from below a virtual line paralleling the plantar cortical line to above this line was present in 50 of 61 instances (82%) between the supine and the weight-bearing positions. When changing from the supine to the weight-bearing position, there was a significant decrease in the distance between the plantar skin and the metatarsal heads for the second (mean 4.5 mm), third (mean 4.4 mm), and fourth metatarsal heads (mean 3.7 mm) (P Ͻ 0.0001). However, the difference for the first (mean 0.5 mm) and fifth (mean 0.9 mm) metatarsal heads was not significant. Conclusion:Weight-bearing MR imaging of the forefoot is feasible using an open-configuration MR system and demonstrates position-related changes of the neurovascular bundles relative to the metatarsal heads, as well as position-related changes of the metatarsal heads themselves.

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“…On the contrary in a study on asymptomatic volunteers Studler et al [30] found an high percentage rate of alterations in the plantar fat pad which may mimic the presence of a neuroma. Dominik et al [31] demonstrated that Morton's neurona appears significantly different during MRI in prone, supine or weight-bearing positions and supported the idea that visibility of Morton neuroma is best in MRI images obtained in the prone position.…”

Section: Diagnosismentioning

confidence: 88%

Morton’s Neuroma

Giannini

Cadossi

Luciani

et al. 2014

European Surgical Orthopaedics and Traumatology

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Morton Neuroma: MR Imaging in Prone, Supine, and Upright Weight-bearing Body Positions

Cited by 81 publications

References 14 publications

Estudo retrospectivo do tratamento cirúrgico do neuroma de morton por via plantar

Estudo retrospectivo do tratamento cirúrgico do neuroma de morton por via plantar

MR imaging of the forefoot under weight‐bearing conditions: Position‐related changes of the neurovascular bundles and the metatarsal heads in asymptomatic volunteers

Morton’s Neuroma

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