THE EFFICACY OF ULTRASOUND GUIDED-STEROID INJECTION IN THE TREATMENT OF INTERDIGITAL METATARSALGIA

Abstract

Objective of the Study: To assess the clinical effectiveness of ultrasound guided injection in the management of Morton’s Metatarsalgia.

Patients and Methods: Patients, that were clinically diagnosed to with interdigital Morton’s neuroma were treated with ultrasound guided injection of local anaesthetic and steroid. Fifty three patients were available for follow-up, and all had detailed telephone questionnaires completed. These questionnaires included a pre and post injection symptom score, as well as a Johnson Satisfaction score.

Results: 69% of patients had ultrasound diagnosis of Morton’s neuroma and 31% had an ultrasound diagnosis of intermetatarsal bursa. Mean follow up was11.4 months (Range: 3-23 months).67% of the patients were satisfied with the results of treatment. At follow up 63% of patients had no limitation in activity levels, and had no need to modify their shoe wear. Of all patients included in the study, only 3 patients have gone on to require surgery for ongoing symptoms.

Conclusion: Some studies have suggested that neither injection nor imaging have a role in the treatment of Morton’s neuroma. This study, however, demonstrate that ultrasound guided placement of local anaesthetic and steroid in either an intermetatarsal bursa or Mor-ton’s neuroma gives a good short and medium term symptom relief and in the majority of cases avoids the need for surgery.