Reviewed By: Pramod Kerkar, MD, FFARCSI

Does Morton’s Neuroma Show Up On MRI?

Yes, Morton neuroma does show up on an MRI. However, the detection and accuracy of Morton neuroma in an MRI is not 100%, but it’s quite accurate. Morton’s neuroma is a clinical diagnosis and usually investigations are not needed to diagnosis since, most of the time the clinical features are very clear. If there is a doubt then investigations such as ultrasound scan or MRI can be performed to confirm the diagnosis and to exclude other conditions. Differentiation of Morton’s neuroma from metatarsalgia, rupture of the plantar plate of the metatarsophalangeal, and plantar bursitis can be difficult. In these situations, MRI can be helpful

MRI is ordered as a routine investigation to diagnose Morton’s neuroma by some doctor’s and there is question whether this is actually necessary and does MRI always detect Morton’s neuroma very accurately. MRI scans detection and accuracy of Morton’s neuroma diagnosis is better than an ultra sound scan but it’s not a 100% accurate diagnosis. There are some instances where clinical and histological diagnosis confirm it’s a Morton’s neuroma, but the MRI diagnosis is different. These differences can be due to technical changes such as the MRI equipment and subjective interpretation of the radiologist.

Many studies have done to evaluate the accuracy of MRI detecting Morton’s neuroma and different results were seen in some studies.

MRI Scan Accuracy In Detecting A Morton’s Neuroma

The study “Role of MRI in Detection of Morton’s Neuroma” done by the American Orthpaedic Foot and Ankle Society. 71 patients diagnosed with Morton’s neuroma who underwent surgery were recruited to this study. The objective of the study was to “evaluate the accuracy of routine MRI and compare it to clinical and histological findings”.

The study results found that MRI done routinely had a lower accuracy in diagnosing Morton’s neuroma than a clinical assessment. Clinical features such as: tenderness at the site, altered sensation between the web space, and positive Mulder’s click were very useful in diagnosing Morton’s Neuroma.

In this study 96% of Morton’s neuroma were confirmed by histological examination. In three patient’s histologic examination was negative however, the clinical examination and MRI scan strongly suggested Morton’s neuroma therefore, 2 patients even underwent surgery and the histopathology report showed an inflamed bursa.

In this study 59 cases of Morton’s neuroma were detected by MRI; the sensitivity was 84% and specificity was 33%. Diagnosis Morton’s neuroma by clinical features had a sensitivity of 94% and specificity of 33%. When both clinical features and MRI scan finding were considered to arrive at the diagnosis the sensitivity was 99%.

The study concludes that the clinical diagnosis is more superior than an MRI scan diagnosis of a Morton’s neuroma and if both clinical diagnosis and MRI scan confirms the diagnosis of a Morton’s neuroma then it’s a very accurate diagnosis. It also says that with the increasing cost of medical investigations in the present day, the expensive and time-consuming MRI scan should not be done routinely to diagnose Morton’s neuroma but to be done when there is a doubt in the clinical diagnosis.

Some of the other studies done had different results. These studies showed that the MRI has a sensitive level of 87 – 98% and a specificity of 100%. These figures were achieved when the following conditions were fulfilled

  • Patient should be in prone position (lying flat down on your chest and stomach)
  • Use of a contrast medium
  • An experienced radiologist opinion

Conclusion

Yes, Morton neuroma does show up on an MRI. However, the detection and accuracy of Morton neuroma in an MRI is not 100% but it’s quite accurate. study “Role of MRI in Detection of Morton’s Neuroma” done by American Orthpaedic Foot and Ankle Society. 71 patients diagnosed with Morton’s neuroma who underwent surgery were recruited to this study. In this study 96% of Morton’s neuroma were confirmed by histological examination. 59 cases of Morton’s neuroma were detected by MRI; the sensitivity was 84% and specificity was 33%. Diagnosis Morton’s neuroma by clinical features had a sensitivity of 94% and specificity of 33%. When both clinical features and MRI scan finding were considered to arrive at the diagnosis the sensitivity was 99%. The study concludes that the clinical diagnosis is more accurate than an MRI scan diagnosis for a correct diagnosis.

Also Read:

Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: March 15, 2019

This article does not provide medical advice. See disclaimer

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