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.

Clinical evaluation, which is fundamental for accurate diagnosis, can make use of dynamic US in the first instance in order to confirm clinical signs and identify the correct site and number of masses. In our opinion, MR maintains a primary role in differential diagnosis with other diseases (mainly stress fractures, bursitis, ganglion cysts or tendon tumour sheaths).