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

Eur Radiol. 2004 Mar;14(3):514-8. doi: 10.1007/s00330-003-2057-7. Epub 2003 Oct 3.

Abstract

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.

MeSH terms

  • 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

Substances

  • Ethanol