ISSN: 1899-0967
Polish Journal of Radiology
Established by prof. Zygmunt Grudziński in 1926 Sun
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1/2021
vol. 86
 
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Musculoskeletal radiology
abstract:
Original paper

Should the webspaces be a review area for Mortons neuroma on computed tomographies performed for metatarsalgia?

Christine Azzopardi
1
,
Emily Smith
1
,
James Kho
1
,
Steven James
1
,
Rajesh Botchu
1

1.
Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham, United Kingdom
Pol J Radiol 2021; 86: e322-e324
Online publish date: 2021/05/25
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Introduction
Morton’s neuroma-bursal complex (MNBC) is a common cause of metatarsalgia which is usually investigated with ultrasound. Patients presenting with metatarsalgia may also have computed tomography (CT) as part of their investigation to look for alternative causes such as stress fracture. Although CT is considered to be of most use in assessing the bones in this scenario, the soft tissues can also be reviewed. This study analyses whether MNBC can reliably be detected on CT in patients presenting with metatarsalgia.

Material and methods
43 cases were identified on the Radiology Information System where both CT and ultrasound had been undertaken to assess for metatarsalgia. Two blinded consultant musculoskeletal radiologists retrospectively reviewed the CTs to determine the presence or absence of MNBC and this was compared to the ultrasound reports.

Results
There was a mean sensitivity of 45.5% and mean specificity of 62.5%. Mean accuracy was 52.3% and Youden’s index was 0.080. There was fair agreement between the two reviewers with Cohen’s κ of 0.62.

Conclusions
Sensitivity and specificity of CT for MNBC are poor. CT should not be used as an isolated modality to make a definite diagnosis regarding the presence or absence of a MNBC.

keywords:

Morton’s neuroma, CT, ultrasound




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