Corticosteroid Injection for Morton's Interdigital Neuroma: A Systematic Review

Choi, Jun Young; Lee, Hyun Il; Hong, Woi Hyun; Suh, Jin Soo; Hur, Jae Won

doi:10.4055/cios20256

Cited by 13 publications

(15 citation statements)

References 28 publications

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“…More recently, Samaila et al [ 45 ], in a cohort of 115 patients treated by injections of 3 mL of a 6% phenol solution, reported a singular case of osteonecrosis of the third metatarsal head 2 years after the last alcoholization in addition to minor complications. Other studies documented similar complications: intolerable transient pain [ 34 ], mean local inflammatory reactions, short-lived pain at the moment of injection [ 35 , 37 ], skin depigmentation, plantar fat pad atrophy [ 47 ], perilesional scar [ 49 ], local cellulitis and hematoma [ 48 , 50 , 51 ]. Finally, Ortu et al [ 38 ] reported that 3 of 200 patients treated by injection of 1 mL of a 47.5% alcohol solution developed skin necrosis with an involvement of subcutaneous tissue and peritendinous exposition, a known effect of alcohol therapy but not previously reported for ultrasound-guided alcohol injection for MN.…”

Section: Discussionmentioning

confidence: 95%

“…For patients not responding to initial conservative measures, the injection of corticosteroids with the addition of anesthetic, chemical neurolysis with alcohol, or radiofrequency ablation, can be performed as a non-surgical mini-invasive measure. However, as reported in Table 1 , non-surgical procedures are not lacking in complications [ 33 , 36 , 37 , 38 , 39 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 ].…”

Section: Discussionmentioning

confidence: 99%

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Digital Ischemia after Ultrasound-Guided Alcohol Injection for Morton’s Syndrome: Case Report and Review of the Literature

Biz

Bonvicini

Sciarretta

et al. 2022

JCM

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The therapeutic algorithm for symptomatic Morton’s syndrome is not standardized as several managements have been proposed. Ultrasound-guided alcohol injection (USGAI) is one of the non-operative procedures described. This report presents the case of digital ischemia that occurred after alcoholization for the treatment of Morton’s syndrome. This complication is described for the first time in the scientific literature, and it should not only be added to the list of sequalae of USGAI, but more importantly, it should also be explained to the patient when this alternative treatment to traditional surgery is proposed.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Digital Ischemia after Ultrasound-Guided Alcohol Injection for Morton’s Syndrome: Case Report and Review of the Literature

Biz

Bonvicini

Sciarretta

et al. 2022

JCM

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show abstract

“…Wherever these methods fail to improve symptoms, minimally invasive procedures such as US-guided injections with corticosteroid or alcohol, or ablations using cryoablation or RFA, are used as second-line treatments to potentially avoid or delay surgery, often providing complete pain relief. 47 US guidance has been shown to offer superior results compared with nonguided injections with more efficient pain reduction, fewer complications, and reduced surgical referrals. 48 In cases of first treatment failure, these procedures can be repeated, often leading to remission of symptoms.…”

Section: Common Pathologiesmentioning

confidence: 99%

“…51 52 It was shown that corticosteroid injections are more effective than local anesthetic alone and more effective if used within a year of symptom onset. 47 52 Although studies have reported up to 30% of subjects receiving steroid injections eventually undergo operative treatment, 47 the failure rate following surgical excision has also been reported in up to 30% of subjects.…”

Section: Common Pathologiesmentioning

confidence: 99%

Interventional Imaging Techniques as Alternative to Surgery of the Foot and Ankle

Burke

Walter

Adler

2022

Semin Musculoskelet Radiol

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A variety of foot and ankle pathologies can impair patient's daily activities, ultimately requiring surgical management. However, with improvements in image-guided intervention, the joints, soft tissues, and osseous structures may be accessible using various percutaneous techniques as a potential alternative therapeutic tool, avoiding the need for surgery with its associated risks and morbidity. This article discusses the potential range of image-guided interventional treatments. Injections, aspiration, biopsies, cryoablation, and radiofrequency ablation are described. Newer novel treatments are also covered. Finally, the common pathologies of Morton's neuroma, Achilles tendinopathy, and plantar fasciitis are addressed.

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“…9 Corticosteroid injection may provide short-term (1 week to 3 months) pain reduction in Morton neuroma. 10,11 The benefit of corticosteroids was quantified in a patient-blinded randomized trial of 131 patients comparing a single injection of methylprednisolone mixed with local anesthetic vs local anesthetic alone. 12 The steroid group demonstrated better improvement on the patient global assessment of foot health scale at 3 months (VAS ranging from 0 [worst imaginable foot health] to 100 [best imaginable foot health]; mean difference, 14.1 points [95% CI, 5.5-22.8]; P = .002).…”

mentioning

confidence: 99%

Common Painful Foot and Ankle Conditions

Cooper

2023

JAMA

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ImportanceMorton neuroma, plantar fasciitis, and Achilles tendinopathy are foot and ankle conditions that are associated with pain and disability, but they can respond to nonoperative treatment.ObservationsMorton neuroma, consisting of interdigital neuronal thickening and fibrosis, is characterized by burning pain in the ball of the foot and numbness or burning pain that may radiate to the affected toes (commonly the third and fourth toes). First-line nonoperative therapy consists of reducing activities that cause pain, orthotics, and interdigital corticosteroid injection; however, approximately 30% of patients may not respond to conservative treatment. Plantar fasciitis accounts for more than 1 million patient visits per year in the US and typically presents with plantar heel pain. Fifteen years after diagnosis, approximately 44% of patients continue to have pain. First-line nonoperative therapy includes stretching of the plantar fascia and foot orthotics, followed by extracorporeal shockwave therapy, corticosteroid injection, or platelet-rich plasma injection. Midportion Achilles tendinopathy presents with pain approximately 2 to 6 cm proximal to the Achilles insertion on the heel. The primary nonoperative treatment involves eccentric strengthening exercises, but extracorporeal shockwave therapy may be used.Conclusions and RelevanceMorton neuroma, plantar fasciitis, and Achilles tendinopathy are painful foot and ankle conditions. First-line therapies are activity restriction, orthotics, and corticosteroid injection for Morton neuroma; stretching and foot orthotics for plantar fasciitis; and eccentric strengthening exercises for Achilles tendinopathy.

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Corticosteroid Injection for Morton's Interdigital Neuroma: A Systematic Review

Cited by 13 publications

References 28 publications

Digital Ischemia after Ultrasound-Guided Alcohol Injection for Morton’s Syndrome: Case Report and Review of the Literature

Digital Ischemia after Ultrasound-Guided Alcohol Injection for Morton’s Syndrome: Case Report and Review of the Literature

Interventional Imaging Techniques as Alternative to Surgery of the Foot and Ankle

Common Painful Foot and Ankle Conditions

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