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21-06-2022 | Ultrasound | Musculoskeletal

Long-term comparison between blind and ultrasound-guided corticoid injections in Morton neuroma

Authors: Fernando Ruiz Santiago, Pablo Tomás Muñoz, Antonio Jesús Láinez Ramos-Bossini, Alberto Martínez Martínez, Nicolás Prados Olleta

Published in: European Radiology | Issue 12/2022

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

• Ultrasound-guided corticosteroid injections in Morton neuroma provide long-term pain relief in more than 75% of patients.

• Ultrasound-guided injections in Morton neuroma led to greater long-term pain relief and less disability than blind injections up to 3 years of follow-up.

• The presence of an ipsilateral neuroma is associated with worse long-term disability score.

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Title: Long-term comparison between blind and ultrasound-guided corticoid injections in Morton neuroma
Authors: Fernando Ruiz Santiago
Pablo Tomás Muñoz
Antonio Jesús Láinez Ramos-Bossini
Alberto Martínez Martínez
Nicolás Prados Olleta
Publication date: 21-06-2022
Publisher: Springer Berlin Heidelberg
Keywords: Ultrasound
Ultrasound
Published in: European Radiology / Issue 12/2022
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-022-08932-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Long-term comparison between blind and ultrasound-guided corticoid injections in Morton neuroma

Abstract

Objectives

Methods

Results

Conclusion

Key Points

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

Key Points

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