Effects of 4% Ethanol Sclerosing Injection on Morton's Neuroma: A Histologic Study

2020 ◽  
Vol 110 (5) ◽  
Author(s):  
Patrick A. DeHeer ◽  
Rickinder S. Bains ◽  
Faye-Rose Grebenyuk ◽  
Shrunjay Patel ◽  
Tea Nguyen
Keyword(s):  
Corticosteroid Injection ◽  
Cellular Level ◽  
Nerve Fibers ◽  
Success Rates ◽  
Inclusion Criteria ◽  
Histologic Study ◽  
Morton’S Neuroma ◽  
Sclerosing Injections ◽  
Morton's Neuroma ◽  
Histologic Changes

Background Nonoperational treatments for Morton's neuroma remain controversial because it is believed that sclerosing injections do not change nerve fibers on a cellular level. Up to 80% success rates with 4% ethanol sclerosing have been documented, and the remainder required operational removal of the painful nerve. We sought to evaluate the histologic characteristics of Morton's neuromas treated with 4% ethanol sclerosing injection versus corticosteroid injection alone in patients who required removal of the nerve for pain relief. Methods A retrospective histologic review was performed of 23 consecutive patients who were treated with either sclerosing injection or nonsclerosing injection and underwent nerve removal between September 1, 2012, and February 28, 2015. Results Of 19 patients who met the inclusion criteria, eight received sclerosing injections and 11 received nonsclerosing injections. Intraneural fibrosis was more severe in the nonsclerosing injection group (P = .008). Conclusion Histologic changes are seen in Morton's neuroma with the use of 4% ethanol sclerosing injection, contrary to findings from previous studies.

Effectiveness of Ultrasound-Guided Corticosteroid Injection in the Treatment of Morton's Neuroma

2008 ◽  
Vol 29 (5) ◽  
pp. 483-487 ◽  
Author(s):  
Maja Markovic ◽  
Ken Crichton ◽  
John W. Read ◽  
Peter Lam ◽  
Henry Kim Slater
Keyword(s):  
Corticosteroid Injection ◽  
Ultrasound Guided ◽  
Morton’S Neuroma ◽  
Morton's Neuroma

scholarly journals Efficacy of a Single Corticosteroid Injection for Morton's Neuroma in Adults: A Systematic Review

2021 ◽  
Vol 111 (4) ◽  
Author(s):  
Steven R. Edwards ◽  
Susannah Fleming ◽  
Karl B. Landorf
Keyword(s):  
Primary Outcome ◽  
Event Rate ◽  
Corticosteroid Injection ◽  
Adverse Event Rate ◽  
Ultrasound Guided ◽  
Medium Term ◽  
Morton’S Neuroma ◽  
Morton's Neuroma ◽  
Corticosteroid Injections

Background Morton's neuroma is a common condition that routinely presents in podiatric practice. The aim of this study was to systematically synthesize the evidence relating to the effectiveness of a corticosteroid injection for Morton's neuroma. Methods Studies with a publication date of 1960 or later were eligible, and searches were performed within the Turning Research Into Practice database; the Cochrane Central Register of Controlled Trials; the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register; MEDLINE (Ovid); PubMed; Embase; Cumulative Index to Nursing and Allied Health Literature; and the gray literature. Study selection criteria included randomized and nonrandomized controlled trials where a single corticosteroid injection for Morton's neuroma pain was investigated. The primary outcome was Morton's neuroma pain as measured by any standard validated pain scale. Results Ten studies involving 695 participants were included. The quality of the studies was considered low and subject to bias. Of the included studies, five compared corticosteroid injection to usual care, one compared corticosteroid injection to local anesthetic alone, one compared ultrasound-guided to non–ultrasound-guided injections, three compared corticosteroid injections to surgery, one compared small to large neuromas, six assessed patient satisfaction, four measured adverse events, one studied return to work, and one examined failure of the corticosteroid injection to improve pain. Overall, these studies identified a moderate short- to medium-term benefit of corticosteroid injections on the primary outcome of pain and a low adverse event rate. Conclusions A single corticosteroid injection appears to have a beneficial short- to medium-term effect on Morton's neuroma pain. It appears superior to usual care, but its superiority to local anaesthetic alone is questionable, and it is inferior to surgical excision. A very low adverse event rate was noted throughout the studies, indicating the intervention is safe when used for Morton's neuroma. However, the quality of the evidence is low, and these findings may change with further research.

Corticosteroid injection for Morton’s neuroma with or without ultrasound guidance

2016 ◽  
Vol 98-B (4) ◽  
pp. 498-503 ◽  
Author(s):  
D. Mahadevan ◽  
M. Attwal ◽  
R. Bhatt ◽  
M. Bhatia
Keyword(s):  
Ultrasound Guidance ◽  
Corticosteroid Injection ◽  
Morton’S Neuroma ◽  
Morton's Neuroma

scholarly journals Corticosteroid Injection for the Treatment of Morton’s Neuroma: A Prospective, Double-Blinded, Randomized, Placebo-Controlled Trial

2017 ◽  
Vol 38 (9) ◽  
pp. 944-951 ◽  
Author(s):  
Xavier Lizano-Díez ◽  
Alberto Ginés-Cespedosa ◽  
Eduard Alentorn-Geli ◽  
Daniel Pérez-Prieto ◽  
Gemma González-Lucena ◽  
...  
Keyword(s):  
Local Anesthetic ◽  
Corticosteroid Injection ◽  
Controlled Trial ◽  
Case Series ◽  
Control Group ◽  
Placebo Control ◽  
Morton’S Neuroma ◽  
Level Of Evidence ◽  
Morton's Neuroma ◽  
And Function

Background: The effectiveness of corticosteroid injection for the treatment of Morton’s neuroma is unclear. In addition, most of the studies related to it are case-control or retrospective case series. The purpose of this study was to compare the effectiveness between corticosteroid injection associated with local anesthetic and local anesthetic alone (placebo control group) for the treatment of Morton’s neuroma. Methods: Forty-one patients with a diagnosis of Morton’s neuroma were randomized to receive 3 injections of either a corticosteroid plus a local anesthetic or a local anesthetic alone. The patients and the researcher who collected data were blinded to the treatment groups. The visual analog scale for pain and the American Orthopaedic Foot & Ankle Score (metatarsophalangeal/interphalangeal score) were obtained at baseline, after each injection, and at 3 and 6 months after the last injection. Results: There were no significant between-group differences in terms of pain and function improvement at 3 and 6 months after treatment completion in comparison with baseline values. At the end of the study, 17 (48.5%) patients requested surgical excision of the neuroma: 7 (44%) in the experimental group and 10 (53%) in the control group ( P = 1.0). Conclusion: The injection of a corticosteroid plus a local anesthetic was not superior to a local anesthetic alone in terms of pain and function improvement in patients with Morton’s neuroma. Level of Evidence: Level I, randomized controlled trial.

Medium-Term Results of Corticosteroid Injections for Morton’s Neuroma

2020 ◽  
pp. 107110072096633
Author(s):  
Melinda Yun Ting Hau ◽  
Lauren Thomson ◽  
Randeep Aujla ◽  
Devendra Madhadevan ◽  
Maneesh Bhatia
Keyword(s):  
Corticosteroid Injection ◽  
Controlled Trial ◽  
Surgical Excision ◽  
Medium Term ◽  
Morton’S Neuroma ◽  
Level Of Evidence ◽  
Satisfaction Scale ◽  
Morton's Neuroma ◽  
Corticosteroid Injections

Background: The objective of this study was to evaluate the medium-term results of corticosteroid injections for Morton’s neuroma. Methods: This was a prospective follow-up study of a previous randomized controlled trial (RCT). Forty-five neuromas in 36 patients were injected with a single corticosteroid injection either with or without ultrasound guidance. As the results of the RCT showed no difference in outcomes between techniques, the data were pooled for the purpose of this study. Questionnaires were sent out and responses were collected via mail or telephone interview. Results were available in 42 out of 45 neuromas. There was a sex split of 68% female/32% male with a mean age of 62.6 years (SD, 12 years). Results: At mean follow-up of 4.8 years (SD, 0.91 years), the original corticosteroid injection remained effective in 36% ( n = 16) of the patients. In these cases, the visual analog scale (VAS) pain score ( P < .001) and Manchester-Oxford Foot Questionnaire Index (MOxFQ Index) ( P = .001) remained significantly better than preintervention scores. The remaining cases underwent either a further injection or surgery. Fifty-five percent of the 11 neuromas that received a second injection continued to be asymptomatic in the medium term. Overall, 44% ( n = 20) of the initial cohort underwent surgical excision by the medium-term follow-up. The VAS score, MOxFQ Index, and satisfaction scale score across all groups were not significantly different. Conclusion: Corticosteroid injections for Morton’s neuroma remained effective in over a third of cases for up to almost 5 years. A positive outcome at 1 year following a corticosteroid injection was reasonably predictive of a prolonged effect from the injection. Level of Evidence: Level II, prospective comparative study.

What factors predict the need for further intervention following corticosteroid injection of Morton's neuroma?

2016 ◽  
Vol 22 (1) ◽  
pp. 9-11 ◽  
Author(s):  
Devendra Mahadevan ◽  
Mohammad Salmasi ◽  
Nicola Whybra ◽  
Anika Nanda ◽  
Suchi Gaba ◽  
...  
Keyword(s):  
Corticosteroid Injection ◽  
Morton’S Neuroma ◽  
Morton's Neuroma

Effectiveness of Ultrasound-Guided Corticosteroid Injection in the Treatment of Morton's Neuroma

2008 ◽  
Vol 29 (5) ◽  
pp. 483-487 ◽  
Author(s):  
Maja Markovic ◽  
Ken Crichton ◽  
John W. Read ◽  
Peter Lam ◽  
Henry Kim Slater
Keyword(s):  
Corticosteroid Injection ◽  
Ultrasound Guided ◽  
Morton’S Neuroma ◽  
Morton's Neuroma

Minimally invasive neurectomy for Morton’s neuroma with Interdigital approach. Long term results

The Foot ◽  
2021 ◽  
pp. 101808
Author(s):  
Héctor José Masaragian ◽  
Fernando Perin ◽  
Leonel Rega ◽  
Nicolas Ameriso ◽  
Luciano Mizdraji ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Long Term Results ◽  
Morton’S Neuroma ◽  
Morton's Neuroma
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