Domenico Albano1,2,3, Carlo Bonifacini4, Stefania Zannoni5, Susan Bernareggi6, Carmelo Messina6, Massimo Galia7, Luca Maria Sconfienza6,8. 1. IRCCS Istituto Ortopedico Galeazzi, Milano, Italy. domenico.albano@unipa.it. 2. Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università di Palermo, Palermo, Italy. domenico.albano@unipa.it. 3. Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122, Milan, Italy. domenico.albano@unipa.it. 4. Foot and Ankle Surgery, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy. 5. Scuola di Specializzazione in Radiodiagnostica, Università Degli Studi di Milano, Milan, Italy. 6. IRCCS Istituto Ortopedico Galeazzi, Milano, Italy. 7. Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università di Palermo, Palermo, Italy. 8. Dipartimento di Scienze Biomediche Per la Salute, Università Degli Studi di Milano, Milano, Italy.
Abstract
PURPOSE: No prior studies investigated the role of ultrasound in the assessment of response of patients undergoing treatment of metatarsalgia with custom-made orthoses. Our aim was to describe ultrasound findings of patients with plantar forefoot pain treated with custom-made foot orthoses. METHODS: Twenty patients (15 females; mean age: 62.6 ± 11 years) affected by metatarsalgia in 27/40 feet underwent clinical evaluation before, three months and six months after treatment with custom-made full foot insole with a support proximal and an excavation below the painful metatarsals. Ultrasound was performed before and three months after the use of orthoses to examine the presence of intermetatarsal/submetatarsal bursitis, metatarsophalangeal joints effusion, anterior plantar fat pad oedema, flexor tendinitis/tenosynovitis, and Morton's neuroma. Outcome measures were clinical response with Foot Function Index (FFI)/Visual Analogue Scale (VAS) and ultrasound features changes. RESULTS: Median VAS and FFI before treatment were 8[5-8.5] and 45.85[32.4-59.4], respectively. After 3 and 6 months of insoles use, both median VAS (2.5 [0-5] and 0 [0-2.75], respectively) and median FFI (7.9 [3.95-20] and 0 [0-3.95], respectively) showed a significant reduction in pain and disability (p < .001). Before treatment, ultrasound revealed 22 intermetatarsal bursitis, 16 submetatarsal bursitis, 10 joint effusions, 20 fat pad oedema, 3 flexor tendinitis/tenosynovitis and 3 Morton's neuromas. After 3 months of treatment, a significant decrease of intermetatarsal bursitis (7, p < .001) was observed. No significant changes were observed in any other ultrasound parameters. CONCLUSION: Ultrasound might be able to detect some imaging features associated with the response of forefoot pain to custom-made foot orthoses, especially intermetatarsal bursitis.
PURPOSE: No prior studies investigated the role of ultrasound in the assessment of response of patients undergoing treatment of metatarsalgia with custom-made orthoses. Our aim was to describe ultrasound findings of patients with plantar forefoot pain treated with custom-made foot orthoses. METHODS: Twenty patients (15 females; mean age: 62.6 ± 11 years) affected by metatarsalgia in 27/40 feet underwent clinical evaluation before, three months and six months after treatment with custom-made full foot insole with a support proximal and an excavation below the painful metatarsals. Ultrasound was performed before and three months after the use of orthoses to examine the presence of intermetatarsal/submetatarsal bursitis, metatarsophalangeal joints effusion, anterior plantar fat pad oedema, flexor tendinitis/tenosynovitis, and Morton's neuroma. Outcome measures were clinical response with Foot Function Index (FFI)/Visual Analogue Scale (VAS) and ultrasound features changes. RESULTS: Median VAS and FFI before treatment were 8[5-8.5] and 45.85[32.4-59.4], respectively. After 3 and 6 months of insoles use, both median VAS (2.5 [0-5] and 0 [0-2.75], respectively) and median FFI (7.9 [3.95-20] and 0 [0-3.95], respectively) showed a significant reduction in pain and disability (p < .001). Before treatment, ultrasound revealed 22 intermetatarsal bursitis, 16 submetatarsal bursitis, 10 joint effusions, 20 fat pad oedema, 3 flexor tendinitis/tenosynovitis and 3 Morton's neuromas. After 3 months of treatment, a significant decrease of intermetatarsal bursitis (7, p < .001) was observed. No significant changes were observed in any other ultrasound parameters. CONCLUSION: Ultrasound might be able to detect some imaging features associated with the response of forefoot pain to custom-made foot orthoses, especially intermetatarsal bursitis.
Authors: Alberto Bellelli; Enzo Silvestri; Antonio Barile; Domenico Albano; Alberto Aliprandi; Roberto Caudana; Vito Chianca; Francesco Di Pietto; Carlo Faletti; Eugenio Genovese; Andrea Giovagnoni; Carlo Masciocchi; Carmelo Messina; Luca Maria Sconfienza; Vincenzo Spina; Marcello Zappia Journal: Radiol Med Date: 2019-01-28 Impact factor: 3.469
Authors: Igino Simonetti; Federico Bruno; Roberta Fusco; Carmen Cutolo; Sergio Venanzio Setola; Renato Patrone; Carlo Masciocchi; Pierpaolo Palumbo; Francesco Arrigoni; Carmine Picone; Andrea Belli; Roberta Grassi; Francesca Grassi; Antonio Barile; Francesco Izzo; Antonella Petrillo; Vincenza Granata Journal: J Pers Med Date: 2022-07-16