role of MRI in the diagnosis of Morton neuroma

ABSTRACT

The main aim of this study was to evaluate the role of MRI in patients suspected of having Morton neuroma [intermetatarsal neuroma], and to assess the importance of the various MRI sequences in this disease. Patients and thirty patients with a clinical suspicion of Morton neuroma were examined with a 1.0 Tesla MRI scanner. T1W axial, T2W axial, fat suppression, and T1W post contrast images were obtained. Sixteen of the 30 patients underwent surgery subsequently. twelve patients of the 16 had Morton neuroma proven. There were 11 true positive, 1 false negative, 4 true negative, and no false positive diagnoses based on MRI. Of the 12 proven Morton neuroma cases, there were 5 cases in which the clinician was unable to localize the exact intermetatarsal space. In the 14 patients who did not undergo surgery the MRI results were as follows 4 Morton neuroma, 1 stress fracture, 2 non-specific fibrosis, and 7 no abnormality. MRI is accurate in the diagnosis and localization of Morton neuroma. T1W images are the most important sequence. T2W images are included to define cystic lesions and bursae. STIR images are of some value. Post Gad T1W images were excluded from the routine sequences and reserved for when other pathology is suspected