Outcomes after partial neurectomy of Morton's neuroma related to preoperative case histories, clinical findings, and findings on magnetic resonance imaging scans

Our purpose was to evaluate the reliability of preoperative case histories, clinical findings, and magnetic resonance imaging (MRI) scans in substanti ating the diagnosis of Morton's neuroma and in predicting clinical outcomes after surgical intermetatarsal neurectomy, We studied 19 consecutive patients with histologically proved Morton's neur oma, All had preoperative MRI of the forefoot, Partial neurectomy was perfo rmed when there was forefoot pain with transmetatarsal compression acid pos itive findings on MRI scans. Case histories, clinical findings, and finding s on MRI scans were correlated with clinical outcomes. Preoperative clinical findings including localization correlated with intra operative findings in 11 of 19 patients (58%), and MRI scans correlated in 16 of 19 patients (84%), Of the 19 patients, 74% achieved satisfactory outc omes. Neither reliable clinical findings or findings on MRI scans nor confi rmation of clinical findings by MRI correlated with a superior result, but 77% of patients with neuromas measuring more than 5 mm in transverse measur ement on MRI scans had good outcomes; only 17% with neuromas measuring 5 mm or less had good outcomes. Preoperative localization and diagnosis of Morton's neuroma is better achie ved with MRI than through clinical findings, A more favorable clinical outc ome can be expected after surgical intermetatarsal neurectomy when a Morton 's neuroma has a transverse measurement larger than 5 mm on MRI scans.