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Am Fam Physician. 2024;110(3):236-237

This clinical content conforms to AAFP criteria for CME.

Author disclosure: No relevant financial relationships.

CLINICAL QUESTION

Are corticosteroid injections and surgical interventions effective in treating Morton neuroma?

EVIDENCE-BASED ANSWER

In patients with Morton neuroma, combined corticosteroid/local anesthetic injection does not improve pain, function, or quality of life at 3 to 6 months vs. local anesthetic injection alone. More adverse events, including skin and plantar fat pad atrophy and hypopigmentation, occur with the addition of a corticosteroid. (Strength of Recommendation [SOR]: B, inconsistent or limited-quality patient-oriented evidence.)

Compared with non–ultrasound-guided corticosteroid/local anesthetic injection, ultrasound-guided injection probably improves pain, function, and patient satisfaction at 6 months with little to no difference in adverse events. (SOR: B, inconsistent or limited-quality patient-oriented evidence.)

There appears to be little to no difference in patient satisfaction or rates of adverse events between plantar incision neurectomy and dorsal incision neurectomy.1 (SOR: B, inconsistent or limited-quality patient-oriented evidence.)

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These are summaries of reviews from the Cochrane Library.

This series is coordinated by Corey D. Fogleman, MD, assistant medical editor.

A collection of Cochrane for Clinicians published in AFP is available at https://www.aafp.org/afp/cochrane.

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