Ultrasound in the assessment of metatarsalgia: a surgical and histological correlation

Abstract

Aims: To assess the reliability of ultrasound in the evaluation of metatarsalgia in a typical clinical setting.

Methods and materials: The clinical records, ultrasound findings, surgical outcome and histology of patients with metatarsalgia referred for ultrasound evaluation were reviewed. All ultrasound examinations were performed by the same operator via a plantar approach using high resolution linear array probes.

Results: Thirty-seven patients were examined, age range 23 to 74, mean 49.6 years; thirty-one were female. Thirty-seven intermetatarsal masses were found in 32 patients. To date 26 patients have undergone surgery and 28 lesions (26 Morton's neuromas, one angiolipoma and one angioleiomyoma) have been excised. There were no false-positive ultrasound examinations. A solitary neuroma was missed. Sensitivity was 96% and positive predictive value 100%.

Conclusion: Ultrasound is a valuable tool in the evaluation of metatarsalgia and has high sensitivity and positive predictive value for the detection of intermetatarsal masses. It provides exact localization prior to surgical resection and detects unsuspected additional lesions.