Treatment of Morton's Neuroma with Alcohol Injection Under Sonographic Guidance: Follow-Up of 101 Cases

• Published in: American journal of roentgenology (1976) Vol. 188; no. 6; pp. 1535 - 1539
• Main Authors: Hughes, Richard J, Ali, Kaline, Jones, Hugh, Kendall, Sue, Connell, David A
• Format: Journal Article
• Language: English
• Published: Leesburg, VA Am Roentgen Ray Soc 01.06.2007; American Roentgen Ray Society
• Subjects: Adult; Aged; Biological and medical sciences; Ethanol - administration & dosage; Female; Follow-Up Studies; Foot Diseases - diagnostic imaging; Foot Diseases - drug therapy; Humans; Injections, Intralesional - methods; Male; Medical sciences; Middle Aged; Neurology; Neuroma - diagnostic imaging; Neuroma - drug therapy; Peripheral Nervous System Neoplasms - diagnostic imaging; Peripheral Nervous System Neoplasms - drug therapy; Treatment Outcome; Tumors of the nervous system. Phacomatoses; Ultrasonography; Sonography; Human; Nervous system diseases; Treatment efficiency; Diseases of the osteoarticular system; Alcohol; Neuroma; Guidance; Foot sole; Pain; Treatment; Surgery; Disease of the foot; Morton metatarsalgia; Infiltration; Peripheral nerve disease; Benign neoplasm
• ISSN: 0361-803X; 1546-3141; 1546-3141
• DOI: 10.2214/AJR.06.1463

Morton's neuroma is a common cause of forefoot pain. For this study, we assessed the efficacy of a series of sonographically guided alcohol injections into the lesion. One hundred one consecutive patients with Morton's neuroma were included in this prospective series. An average of 4.1 treatments per person were administered, and follow-up images were obtained at a mean of 21.1 months after the last treatment (range, 13-34 months). Technical success was 100%. Partial or total symptom improvement was reported by 94% of the patients, with 84% becoming totally pain-free. The median visual assessed pain score decreased from 8 before treatment to 0 after treatment (p < 0.001). Transitory increased local pain occurred in 17 cases (16.8%). There were no major complications. Thirty patients underwent sonography at 6 months after the last injection and showed a 30% decrease in the size of the neuroma. We conclude that alcohol injection of Morton's neuroma has a high success rate and is well tolerated. The results are at least comparable to surgery, but alcohol injection is associated with less morbidity and surgical management may be reserved for nonresponders.