US and MRI of the Forefoot: Intermetatarsal Bursitis or Morton's Neuroma
- Conditions
- Intermetatarsal BursitisIntermetatarsal NeuromaMorton Neuroma
- Interventions
- Diagnostic Test: MRI with contrastDiagnostic Test: Ultrasound
- Registration Number
- NCT05685160
- Lead Sponsor
- Rigshospitalet, Denmark
- Brief Summary
The aim of this study is to investigate the incidence of intermetatarsal bursitis and Morton's neuroma in patients with metatarsalgia (i.e. pain in the forefoot) and control subjects by diagnostic imaging with ultrasound and MRI.
- Detailed Description
In a group of patients with intermetatarsal pain found by an orthopedic surgeon, the investigators want to assess the incidences of intermetatarsal bursitis and Morton's neuroma, using diagnostic imaging; ultrasound and MRI.
The hypothesis is, that intermetatarsal bursitis is an overlooked diagnosis in patients with metatarsalgia. As a result of sparse literature and lack of knowledge about this condition with symptoms mimicking Morton's neuroma, a part of patients diagnosed with Morton's neuroma, suffers from intermetatarsal bursitis instead.
Additionally, the investigators want to evaluate the clinical sign opening toes.
Based on clinical photos of the feet, the investigators want to document the presence of opening toes and investigate if there is a correlation with either intermetatarsal bursitis and/or Morton's neuroma.
Recruitment & Eligibility
- Status
- ENROLLING_BY_INVITATION
- Sex
- All
- Target Recruitment
- 75
- Age > 18 years
- Pain in an intermetatarsal space (patient group)
- Age <18 years
- Open wounds or ongoing infection in the forefoot at the time of examination
- Persons with contraindications to participate in MRI scan
- Persons with a history of significant trauma in the forefoot, e.g. any fracture or previous surgeries in the forefoot
- Persons who have previously received treatment for Morton's neuroma in the same foot, e.g. injection (within 6 months) or operation (anytime)
- Persons with severely impaired renal function (GFR <30 ml/min)
- Persons with a systemic inflammatory condition like rheumatoid arthritis, due to clinically silent intermetatarsal bursitis in this group (control group)
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Patient group Ultrasound Patients with intermetatarsal pain have ultrasound and MRI done Control group Ultrasound Healthy individuals (no forefoot pain) undergo ultrasound and MRI scan of the forefoot. Control group MRI with contrast Healthy individuals (no forefoot pain) undergo ultrasound and MRI scan of the forefoot. Patient group MRI with contrast Patients with intermetatarsal pain have ultrasound and MRI done
- Primary Outcome Measures
Name Time Method Incidence of intermetatarsal bursitis on MRI 8 weeks High intensity on T2 weighted images, low signal on T1. Thin peripheral enhancement on T1 contrast enhanced pictures.
Incidence of intermetatarsal bursitis on US 8 weeks Hypoechoic mass between metatarsal heads closest to dorsal surface of foot. Compressible. Activity on power/color doppler.
Incidence of Morton's neuroma on MRI 8 weeks Low to Intermediate signal in T1 and T2. Contrast enhancement of the nodular focus.
Incidence of Morton's neuroma on US 8 weeks Hypoechoic mass between metatarsal heads closest to plantar surface of foot. Non-compressible. The interdigital nerve can be seen entering the mass. Close relation to the interdigital artery.
Incidence of other pathology on MRI 8 weeks Other pathology than intermetatarsal bursitis or Morton's neuroma.
Incidence of other pathology on US 8 weeks Other pathology than intermetatarsal bursitis or Morton's neuroma.
Incidence of normal findings on MRI 8 weeks When no findings is observed.
Incidence of normal findings on US 8 weeks When no findings is observed.
- Secondary Outcome Measures
Name Time Method Opening toes 8 weeks Presence of opening toes/V-sign/spreading toes.
Trial Locations
- Locations (1)
Department of Radiology
🇩🇰Copenhagen, Denmark