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Treatment of Morton's Neuroma with Alcohol Injection Under Sonographic Guidance: Follow-Up of 101 Cases

Richard J. Hughes1, Kaline Ali1, Hugh Jones2, Sue Kendall3 and David A. Connell1

1 Department of Radiology, Royal National Orthopaedic Hospital and Kingston Hospital NHS Trust, Brockley Hill, Stanmore, Middlesex HA7 4LP, United Kingdom.
2 Department of Rheumatology, Royal National Orthopaedic Hospital and Kingston Hospital NHS Trust, Middlesex, United Kingdom.
3 Department of Orthopaedic Surgery, Royal National Orthopaedic Hospital and Kingston Hospital NHS Trust, Middlesex, United Kingdom.


Figure 1
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Fig. 1 Photograph shows scanning position for percutaneous access to neuroma with ultrasound probe directed perpendicular to long axis of metatarsals.

 

Figure 2
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Fig. 2 46-year-old woman with Morton's neuroma. Sonogram shows that needle tip is within hypoechoic mass of neuroma (arrow).

 

Figure 3
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Fig. 3A 58-year-old woman with Morton's neuroma. Sonogram shows classical appearance of hypoechoic mass within second–third interspace (arrows) before treatment.

 

Figure 4
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Fig. 3B 58-year-old woman with Morton's neuroma. At follow-up imaging 6 months after treatment, sonogram shows there is developing high echotexture within center of neuroma (arrow).

 

Figure 5
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Fig. 4A Photographs show gross specimens of one neuroma treated with alcohol injections and another neuroma not treated with injections in 51-year-old woman. Surgically resected specimen that was treated with alcohol injection. Mass was within second–third metatarsal interspace; arrow outlines neuroma. There was histologic evidence of fibrosis and reduced cellularity in microscopic sections of posttreatment specimen (not shown).

 

Figure 6
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Fig. 4B Photographs show gross specimens of one neuroma treated with alcohol injections and another neuroma not treated with injections in 51-year-old woman. Surgically resected specimen that was not treated with alcohol injection. Mass was within third–fourth interspace. Arrow points to neuroma.

 

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