RESUMO
The results of 79 high resolution ultrasound examinations of the forefoot that were performed for suspected Morton's metatarsalgia were retrospectively assessed. Scans were only obtained if the pain was poorly localized or if there were atypical features that made the clinical diagnosis uncertain. Ultrasound detected 92 hypoechoic intermetatarsal web space masses in 63 patients. Surgery was performed on 23 web spaces in 22 patients where the response to nonsurgical management had been poor. The surgical specimens were retrieved and reviewed by a pathologist in 21 cases. The histopathology in 20 of 21 operated cases was that of Morton's neuroma; however, prominent mucoid degeneration was also found to involve the adjacent loose fibroadipose tissues in 19 of 20 neuroma specimens. Ultrasound was sensitive in the detection of web space abnormality (sensitivity, 0.95), but could not clearly separate Morton's neuroma from associated mass-like mucoid degeneration in the adjacent loose connective tissues. The implications of these observations for both diagnosis and treatment are discussed.
Assuntos
Doenças do Pé/diagnóstico por imagem , Antepé Humano/diagnóstico por imagem , Neuroma/diagnóstico por imagem , Dor/diagnóstico por imagem , Adolescente , Adulto , Idoso , Reações Falso-Positivas , Feminino , Doenças do Pé/etiologia , Doenças do Pé/patologia , Doenças do Pé/cirurgia , Antepé Humano/cirurgia , Humanos , Masculino , Metatarso , Pessoa de Meia-Idade , Neuroma/etiologia , Neuroma/patologia , Neuroma/cirurgia , Dor/patologia , Dor/cirurgia , Estudos Retrospectivos , UltrassonografiaRESUMO
Forty-two patients with clinically-definite multiple sclerosis were examined by magnetic resonance imaging using a 1.5-T instrument. Magnetic resonance imaging detected an abnormality in 90% of patients. In four patients, no lesions were demonstrated. The number, size and site of the lesions by magnetic resonance imaging were compared with the patients' clinical status and other variables. The Kurtzke disability status scale score increased in patients with corpus callosum atrophy, and brainstem and basal ganglia lesions, and correlated with the total number of lesions. No correlation was shown between the findings of magnetic resonance imaging and disease duration, age, sex or pattern-reversal visual-evoked potentials. This article highlights the variety of magnetic resonance images that is obtained in patients with clinically-definite multiple sclerosis.
