Abstract | OBJECTIVES: This work compares the effectiveness of blind versus ultrasound (US)-guided injections for Morton neuroma (MN) up to 3 years of follow-up. METHODS: This is an evaluator-blinded randomised trial in which 33 patients with MN were injected by an experienced orthopaedic surgeon based on anatomical landmarks (blind injection, group 1) and 38 patients were injected by an experienced musculoskeletal radiologist under US guidance (group 2). Patients were assessed using the visual analogue scale and the Manchester Foot Pain and Disability index (MFPDI). Injections consisted of 1 ml of 2% mepivacaine and 40 mg triamcinolone acetonide in each web space with MN. Up to 4 injections were allowed during the first 3 months of follow-up. Follow-up was performed by phone calls and/or scheduled consultations at 15 days, 1 month, 45 days, 2 months, 3 months, 6 months and 1, 2 and 3 years. Statistical analysis was performed using unpaired Student's t tests. RESULTS: No differences in age or clinical measures were found at presentation between group 1 (VAS, 8.5 ± 0.2; MFPDI, 40.9 ± 1.1) and group 2 (VAS, 8.4 ± 0.2; MFPDI, 39.8 ± 1.2). Improvement in VAS was superior in group 2 up to 3 years of follow-up (p < 0.05). Improvement in MFPDI was superior in group 2 from 45 days to 2 years of follow-up (p < 0.05). Satisfaction with the treatment was higher in group 2 (87%) versus group 1 (59.1%) at 3 years of follow-up. CONCLUSION: Ultrasound-guided injections lead to a greater percentage of long-term improvement than blind injections in MN. KEY POINTS:
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Authors | Fernando Ruiz Santiago, Pablo Tomás Muñoz, Antonio Jesús Láinez Ramos-Bossini, Alberto Martínez Martínez, Nicolás Prados Olleta |
Journal | European radiology
(Eur Radiol)
Vol. 32
Issue 12
Pg. 8414-8422
(Dec 2022)
ISSN: 1432-1084 [Electronic] Germany |
PMID | 35726101
(Publication Type: Randomized Controlled Trial, Journal Article)
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Copyright | © 2022. The Author(s), under exclusive licence to European Society of Radiology. |
Chemical References |
- Mepivacaine
- Adrenal Cortex Hormones
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Topics |
- Humans
- Morton Neuroma
(diagnostic imaging, drug therapy)
- Mepivacaine
(therapeutic use)
- Adrenal Cortex Hormones
(therapeutic use)
- Neuroma
(diagnostic imaging, drug therapy)
- Pain
(drug therapy)
- Ultrasonography, Interventional
- Treatment Outcome
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