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Sonography of Morton's Neuromas

Timothy J. Quinn1, Jon A. Jacobson1, Joseph G. Craig2 and Marnix T. van Holsbeeck2

1 Department of Radiology, University of Michigan Medical Center, 1500 E. Medical Center Dr. TC-2910G, Ann Arbor, MI 48109-0326.
2 Department of Radiology, Henry Ford Hospital, 2799 W. Grand Blvd., Detroit, MI 48202.



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  		Fig. 1. —Normal intermetatarsal space in 34-year-old asymptomatic man not included in study group. Sonogram of third intermetatarsal space in coronal plane (transverse to metatarsal shafts) shows normal hyperechoic fat (open arrows) between echogenic, shadowing cortex of adjacent metatarsals (arrowheads). P = plantar, D = dorsal.

 


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  		Fig. 2A. —Morton's neuroma in 49-year-old woman (true-positive case). P = plantar, D = dorsal. Sonogram of third intermetarsal space in coronal plane shows round, hypoechoic mass between hyperechoic metatarsal heads (3 and 4). Mass (arrowheads) extends both dorsal and plantar to level of plantar aspect of metatarsal heads.

 


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  		Fig. 2B. —Morton's neuroma in 49-year-old woman (true-positive case). P = plantar, D = dorsal. Sonogram in sagittal plane reveals characteristic oval shape of neuroma (arrowheads). Note focal anechoic region (solid arrow) with posterior acoustic enhancement (open arrow) possibly representing intermetatarsal bursa.

 


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  		Fig. 3A. —Ganglion cyst in 39-year-old man (false-positive case). P = plantar, D = dorsal. Sonogram of third intermetatarsal space in coronal plane shows mixed echogenicity mass (arrowheads) between metatarsal heads (iii and iv). Note dorsal and plantar extent of soft-tissue mass relative to metatarsals.

 


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  		Fig. 3B. —Ganglion cyst in 39-year-old man (false-positive case). P = plantar, D = dorsal. Sonogram in sagittal plane shows mass (arrowheads) with length of 30 mm.

 


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  		Fig. 4A. —Giant cell tumor of tendon sheath in 21-year-old woman. P = plantar, D = dorsal. Sonogram of third intermetarsal space in coronal plane shows intermetatarsal mass (arrowheads) of mixed (hypoechoic and isoechoic) echotexture extending both dorsal and ventral to metatarsal heads (III and IV).

 


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  		Fig. 4B. —Giant cell tumor of tendon sheath in 21-year-old woman. P = plantar, D = dorsal. Sonogram in sagittal plane shows mass (arrowheads) with length of 28 mm.

 


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  		Fig. 5. —Morton's neuroma in 56-year-old woman with presumed plantar digital nerve continuity. Sonogram of third interdigital space in sagittal plane reveals hypoechoic plantar digital nerve (arrows) entering proximal aspect of hypoechoic neuroma (arrowheads). P = plantar, D = dorsal.

 

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