Publications

Authors:

Perini, Luciano; Perini, Claudia; Tagliapietra, Matteo; Varotto, Davide; Valcarenghi, Andrea; Postorino, Andrea; Volpe, Antonio

Title:

Percutaneous alcohol injection under sonographic guidance in Morton's neuroma: follow-up in 220 treated lesions

Year:

2016

Type of item:

Articolo in Rivista

Tipologia ANVUR:

Articolo su rivista

Language:

Inglese

Format:

A Stampa

Referee:

Sì

Name of journal:

Radiologia Medica

ISSN of journal:

0033-8362

N° Volume:

121

Number or Folder:

7

Page numbers:

597-604

Keyword:

absolute alcohol; diseases; intralesional injection; neuroma; peripheral nerve; ultrasound

Short description of contents:

PURPOSE: To evaluate the efficacy and safety of percutaneous treatment of Civinini-Morton's syndrome due to solitary Morton's neuroma and analyze the effect of clinico-demographic factors on outcome.MATERIALS AND METHODS: Alcohol injection was performed under sonographic guidance in 220 consecutive patients. Pain intensity using a numerical rating scale (NRS), pain features, limitation of everyday activities and comorbidity with other forefoot conditions were evaluated at presentation. Patients were reassessed for symptoms and the need of rescue therapy with neurectomy after a mean follow-up of 19.0 months (range 15-24).RESULTS: We treated 220 patients (33 males, mean age 55.8 years). Neuromas were located in the III intermetatarsal space in 85.5 %, with a mean size of 5.4 mm. When considering a reduction of pain intensity of ≥50 % of NRS or a complete disappearance of the neuropathic features as a satisfactory clinical response, a 72.3 % (p < 0.001) responder rate was obtained, and only three patients relapsed (1.2 %). An improvement in limitation of everyday activities was observed in 88.6 % (p < 0.001). No influence of clinico-demographic variables on outcome was found. No major complications occurred. Patients with unsatisfactory response had an overload-related comorbid condition in 20/61 (32.8 %). Surgery was later performed in 14 non-responder patients.CONCLUSIONS: Ultrasound-guided alcoholization demonstrated a safe profile, relieved neuropathic symptoms in a majority of patients and improved their quality of life. Rescue therapy with surgery is feasible in patients with unsatisfactory response. However, a thorough evaluation for forefoot comorbidities should be obtained, as they may act as confounding factors.

Web page:

http://dx.doi.org/10.1007/s11547-016-0622-9

Product ID:

93778

Handle IRIS:

11562/944857

Last Modified:

November 25, 2022

Bibliographic citation:

Perini, Luciano; Perini, Claudia; Tagliapietra, Matteo; Varotto, Davide; Valcarenghi, Andrea; Postorino, Andrea; Volpe, Antonio, Percutaneous alcohol injection under sonographic guidance in Morton's neuroma: follow-up in 220 treated lesions «Radiologia Medica» , vol. 121 , n. 7 , 2016 , pp. 597-604

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