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The purpose of this study was to compare the diagnostic accuracy of both ultrasonography (US) and magnetic resonance imaging (MRI) for the assessment of Morton neuroma. Our study group was comprised of 20 neuromas from 17 patients, and the neuromas were confirmed on surgery following evaluation with US, MRI, or both US and MRI. The diagnostic criterion for Morton neuroma, as examined by US, was the presence of a round or ovoid, well-defined, hypoechoic mass. The diagnostic criterion, based on MR imaging, was a well defined mass with intermediate to low signal intensity on both the T1- and T2-weighted images. The retrospective comparison between the sonographic and MR images was done by two experienced radiologists working in consensus with the surgical and pathologic correlations. The detection rate of Morton neuroma was 79% for 14 neuromas from 11 patients who had undergone US followed by an operation. The detection rate was 76% for 17 neuromas from 15 patients who had undergone MRI and a subsequent operation. The mean size of the examined neuromas was 4.9 mm on the US images and it was 5.1 mm on the MRI studies. Ten neuromas (71%) were 5 mm or less as measured by US, and three neuromas were not detected, whereas on the MRI analysis, 10 neuromas (59%) were 5 mm or less and four neuromas were not visualized. Among the patients examined during postoperative follow-up, symptoms were completely relieved in 85% and the symptoms were partially relieved in 15%. US and MR imaging are comparable modalities with high detection rate for the evaluation of Morton neuroma.

To evaluate the MR imaging findings of painful type II accessory navicular bone and to correlate these with the surgical and pathologic findings. The MR images of 17 patients with medial foot pain and surgically proven type II accessory navicular abnormalities were reviewed. The changes of signal intensity in the accessory navicular, synchondrosis and adjacent soft tissue, the presence of synchondrosis widening, and posterior tibial tendon (PTT) pathology on the T1-weighted and fat-suppressed T2-weighted images were analyzed. The MR imaging findings were compared with the surgical and pathologic findings. The fat-suppressed T2-weighted images showed high signal intensity in the accessory navicular bones and synchondroses in all patients, and in the soft tissue in 11 (64.7%) of the 17 patients, as well as synchondrosis widening in 3 (17.6%) of the 17 patients. The MR images showed tendon pathology in 12 (75%) of the 16 patients with PTT dysfunction at surgery. The pathologic findings of 16 surgical specimens included areas of osteonecrosis with granulomatous inflammation, fibrosis and destruction of the cartilage cap. The MR imaging findings of painful type II accessory navicular bone are a persistent edema pattern in the accessory navicular bone and within the synchondrosis, indicating osteonecrosis, inflammation and destruction of the cartilage cap. Posterior tibial tendon dysfunction was clinically evident in most patients.

To describe the MR findings of bone marrow edema syndrome (BMES) of the foot and its evolution at 1 year follow-up. Twenty-five of 32 patients with disabling foot and ankle pain unrelated to trauma diagnosed as BMES when MR imaging demonstrated a bone marrow edema pattern in one or more bones without any radiological or underlying clinical cause, were re-evaluated by MR imaging 1 year later. On the initial MR examinations an average of 4.7 individual bones were involved by bone marrow edema. Soft tissue edema was present in every patient and joint effusion in 10 patients. MR imaging at 1 year showed resolution of bone edema in 18 patients (72%), partial improvement in five (20%) and no improvement in two (8%). Six patients (24%) developed similar symptoms in the other foot during follow-up. Ten of 17 available plain radiographs showed some loss of radiodensity. Further bone marrow edema developed in bones of the same foot that were initially normal, or in uninvolved distant bone marrow areas in the same affected bone, in six of seven patients on follow-up MR imaging. The evolution of the MR findings of BMES of the foot is to complete resolution or partial improvement at 1 year in the majority of cases. Migration to the other foot occurs in up to a quarter of patients.

To assess the frequency of malalignment in the 1st, 2nd and 3rd tarso-metatarsal joints (Lisfranc joint) in cadaveric specimen and asymptomatic individuals utilizing oblique axial MR images. Four fresh frozen cadaveric feet were dissected in the oblique axial plane at 5 mm slice thickness. Thirty MR studies in 29 patients who had no history of pain, trauma or surgery at the tarso-metatarsal area were included in our study. The 1st to 3rd tarso-metatarsal joints were evaluated on the MR studies and cadaveric slices by two musculoskeletal radiologists for (1) the presence of a medial and/or lateral step-off and (2) articular surface divergence. In the cadaveric dissections there were lateral step-offs in the 1st ( n=3) and in the 2nd ray ( n=3) respectively. No joint incongruity was evidenced. The MR studies in the patients population depicted 28 step-offs (9 medial, 19 lateral) in the 1st ray, 16 (2 medial, 14 lateral) in the 2nd ray and two in the 3rd ray. Joint incongruity was present in the 2nd ray ( n=6) and in the 3rd ray ( n=12). All the above findings were limited to a few images. Isolated joint malalignment with otherwise normal findings (no ligamentous injury, no fracture and no bone marrow edema) might reflect normal anatomic features at the tarso-metatarsal joints and must be interpreted carefully.

New Year messages of the party leaders (pg. 1). wage claims (pg. 1-3). the party programmes (pg. 3-7). election policy of the Liberals (pg. 7-8). election campaign (pg. 8-14). polling (pg. 14-15). analysis of results (pg. 15-23).

Dublin Scioto High School's Nick Goings, a first-team All-Ohioan and a finalist for The Associated Press Mr. Football award, announced this week he will attend Ohio State.

Continued optimism (pg. 24-25). H.M.S. Amethyst (pg. 25-26). visit of Commonwealth Prime Ministers (pg. 26). Western Union (pg. 26-27). lifting of Berlin blockade (pg. 27). Foreign Ministers' conference (pg. 27-28). parliamentary debates (pg. 28-30). Church questions (pg. 30). Eire's independence (pg. 30-33). progress of nationalised industries (pg. 33-34). Labour Believes in Britain (pg. 34-36). local elections (pg. 36-37). Blackpool conference of Labour Party (pg. 37-40). dock strikes (pg. 40-42). new economic crisis (pg. 42-43). the dollar problem reviewed (pg. 43). Sir S. Cripps' statement, 6 July (pg. 43-46). The Right Road for Britain (pg. 46-48).

Party strength and by-elections (pg. 13-16). the Scarborough conference (pg. 16-17). the nationalised industries (pg. 17-23). the Monopoly Bill (pg. 23). the film industry (pg. 23-25). the Parliament Bill (pg. 25). Representation of the People Bill (pg. 25-29). the Criminal Justice Bill (pg. 29-31). the national health service (pg. 31-34).