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Ultrasound guided injection of Mortonís neuroma

According to the results of Santiago et al. (2018), injection of Mortonís neuroma (MN) under ultrasound guidance is worthwhile because a statistically significant improvement was observed compared with blind injection at some stages of the follow-up.
MN is a frequent pathology, mainly in middle-aged females, with a female to male ratio of ? 5:1. It arises from the common plantar digital and proper plantar digital nerves, mainly in the second and third web spaces. The location in the first and fourth web spaces is extremely rare. It is considered to be secondary to mechanical stress over the nerves, leading to fibrosis in and around the neural tissue.

Imaging methods are useful in confirming the diagnosis of MN and excluding other causes of forefoot pain, such as metatarsophalangeal arthritis or intermetatarsal bursitis. The available evidence suggests that ultrasound is more accurate for the diagnosis of Mortonís neuroma than MRI.