US and MRI of the Forefoot: Intermetatarsal Bursitis or Morton's Neuroma

N/AEnrolling By InvitationNCT05685160

Rigshospitalet, Denmark75 enrolled

Overview

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.

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.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

DIAGNOSTIC

Masking

NONE

Enrollment

Conditions

Intermetatarsal Bursitis Morton Neuroma Intermetatarsal Neuroma

Interventions

MRI with contrastDIAGNOSTIC_TEST

MRI of the forefoot with contrast (Gadovist)

UltrasoundDIAGNOSTIC_TEST

Ultrasound imaging of the forefoot

Eligibility

Sex: ALLMin age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Age \> 18 years * Pain in an intermetatarsal space (patient group) Exclusion Criteria: * 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)

Locations (1)

Department of Radiology

Copenhagen, Denmark

Outcomes

Primary Outcomes

Incidence of intermetatarsal bursitis on MRI

High intensity on T2 weighted images, low signal on T1. Thin peripheral enhancement on T1 contrast enhanced pictures.

Time frame: 8 weeks

Incidence of intermetatarsal bursitis on US

Hypoechoic mass between metatarsal heads closest to dorsal surface of foot. Compressible. Activity on power/color doppler.

Time frame: 8 weeks

Incidence of Morton's neuroma on MRI

Low to Intermediate signal in T1 and T2. Contrast enhancement of the nodular focus.

Time frame: 8 weeks

Incidence of Morton's neuroma on US

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.

Time frame: 8 weeks

Incidence of other pathology on MRI

Other pathology than intermetatarsal bursitis or Morton's neuroma.

Time frame: 8 weeks

Incidence of other pathology on US

Other pathology than intermetatarsal bursitis or Morton's neuroma.

Time frame: 8 weeks

Incidence of normal findings on MRI

When no findings is observed.

Time frame: 8 weeks

Incidence of normal findings on US

When no findings is observed.

Time frame: 8 weeks

Secondary Outcomes

Data from ClinicalTrials.gov

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