Question
Hi,
I am very confused right now and don't know what to do. It's been a year fighting with neuroma. Ultrasound test said I have 13mm and 14mm neuroma for both feet between second and third.  I had one conrtizone injection which did not help at all and two alcohol injections between second and third toes and two between alcohol injections.  I can not walk and stand barefoot at all.  Before those injections I could be barefoot but after those injections My foot got worst.  I feel like I am stepping on a stick across my ball of feet. I was thinking to have cryosugery or Radiof frequency ablation or surgery, so, I took two MRI tests (3T contrast) but show no neuroma but very small capsular tear.  My podiatrist said it should be seen if neuroma is that big but no showing in the MRI.  All podiatrists and othor doctors said my fat pad is ok.  I am lost.  Looking at ultrasound test, they said neuroma, but by MRI they said no neuroma.  Do you have any suggestion?  I am sorry for long post.
Thank you.

Answer
Hi Sung,

When making the diagnosis of neuroma, there are many factors.  The most important is the doctors exam and evaluation of your symptoms.  Ultrasound and MRI are just tools to help with that diagnosis.  I  personally have found ultrasound to be suoperior to MRI and in many cases, the neuroma is missed.

I am partial to cryosurgery and I perform a thorough exam using ultrasound and small injections of anesthetic to confirm my diagnosis.  If cryosurgery does not work then you could still have traditional surgery.

It is possible to have a capsule tear that can cause neuroma type symptoms or the tear can be present with a neuroma.

I would only be able to give you a solid answer after seeing you as a patient.

Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
http://www.thetampapodiatrist.com
http://www.tampacryosurgery.com
http://katzpodiatristtampa.blogspot.com
http://painfoot.blogspot.com
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http://www.notoenailfungus.com
http://www.vibranttampatoenails.com  
http://www.fixfootpain.com
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