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Ultrasound versus magnetic resonance imaging for Morton neuroma: systematic review and meta-analysis

  • Musculoskeletal
  • Published:
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Abstract

Objectives

To compare ultrasound (US) and magnetic resonance imaging (MRI) in the diagnosis of Morton’s neuroma.

Methods

Studies that assessed the diagnostic accuracy of US and MRI for Morton’s neuroma were retrieved from major medical libraries independently by two reviewers up to 1 April 2014. Predefined inclusion and exclusion criteria were adopted.

Results

277 studies were initially found, and the meta-analysis was conducted on 14 studies. US sensitivity was studied in five studies, MRI sensitivity in three studies, and bothin six studies. All studies used surgery as the reference standard. A high sensitivity (SE) of diagnostic testing was observed for both US (SE (95 % CI) = 0.91 (0.83–0.96)) and MRI (SE (95 % CI) = 0.90 (0.82–0.96)) with no significant differences between the two modalities in diagnosis (Q test p = 0.88). For MRI, specificity of test was 1.00 with a pooled estimation of 1.00 (0.73–1.00), while the pooled specificity was 0.854 (95 % CI: 0.41–1.00) for US. No differences were observed between US and MRI in study design (p = 0.76).

Conclusion

This meta-analysis shows that the SE of US (0.91) is equal to (p = 0.88) that of MRI (0.90) for identification of Morton’s neuroma.

Key points

For Morton’s neuroma, US sensitivity is equal to MRI.

US is as accurate as MRI in diagnosing Morton’s neuroma.

US may be the most cost-effective imaging method for Morton’s neuroma.

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Abbreviations

PRISMA:

preferred reporting items for systematic reviews and meta-analyses

TP:

true positive

TN:

true negative

FP:

false positive

FN:

false negative

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Acknowledgments

The scientific guarantor of this publication is Alberto Tagliafico, MD. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work was partially funded by the University of Genoa. The statistical analysis was done entirely by two professional biostatisticians with specific expertise in meta-analysis: Prof. Maria Pia Sormani and Alessio Signori, PhD candidate. Institutional Review Board approval is not required for a meta-analysis. Methodology: Systematic review and meta-analysis.

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Correspondence to Alberto Tagliafico.

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Bignotti, B., Signori, A., Sormani, M.P. et al. Ultrasound versus magnetic resonance imaging for Morton neuroma: systematic review and meta-analysis. Eur Radiol 25, 2254–2262 (2015). https://doi.org/10.1007/s00330-015-3633-3

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  • DOI: https://doi.org/10.1007/s00330-015-3633-3

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