Morton’s neuroma ultrasound: visualizing Vs diagnosing Morton’s neuroma
What is the exact effectiveness and role of ultrasound in Morton’s neuroma? We still get a lot of questions about ultrasound in Morton’s neuroma. The key is that use and role of ultrasound in Morton’s varies in diagnosis versus treatment.
Ultrasound has different roles in treating Morton’s neuroma versus diagnosing Morton’s neuroma.
Treatment: Ultrasound is extremely helpful in visualizing Morton’s neuroma. This is the key component in ultrasound-guided procedures. Ultrasound guidance increases the accuracy and effectiveness of procedures that we use to treat Morton’s neuroma.
Diagnosis: Visualizing Morton’s neuroma also helps with excluding other diagnoses but just because you can see and visualize the Morton’s neuroma doesn’t mean you can make the diagnosis. Many people have asymptomatic Morton’s and the size of a Morton’s neuroma is not correlated to the level of pain. This means that just because we can visualize your Morton’s neuroma, doesn’t mean that your foot pain is due to your Morton’s.
Furthermore, even if you can’t see a Morton’s neuroma on MRI or Ultrasound, you may still have a very small Morton’s that that is too small to be seen clearly on an Ultrasound or an MRI but still causes all your pain and discomfort. (Remember the size is not correlated to the level of pain.)
The diagnosis of Morton’s neuroma is a clinical diagnosis i.e. not a diagnosis that is made by any radiological test. It can be a difficult diagnosis.
If there is any uncertainty, you should have a diagnostic injection performed by a clinician experienced in these to confirm the diagnosis.
Janet D. Pearl, MD, MSc is the Medical Director of The Center for Morton’s Neuroma and Complete Spine and Pain Care, an interventional and integrated Pain Management program located in Framingham, Massachusetts. Previously, Dr. Pearl was the Co-Director of the Pain Management Center at St. Elizabeth’s Medical Center, where she was also the Director of the Fellowship program. She is the former Director of a satellite pain center of the Brigham and Women’s Hospital, Pain Management Center, located at the HealthSouth Braintree Rehabilitation Hospital. Dr. Pearl held academic appointments at Harvard Medical School and Tufts Medical School. She serves on the Health Care Services Board of the Commonwealth of Massachusetts Department of Industrial Accidents since 2000 as one of its physician representatives and is Chair of the Committee on Pain Management.