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High-Resolution Ultrasound and MRI Imaging of Peroneal Tendon Injuries

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The Peroneal Tendons

Abstract

Imaging of patients with suspected peroneal tendon disorders should include weight-bearing radiographs of the ankle and foot as they are useful for the detection of avulsion fractures and for the evaluation of cavovarus alignment. Advance imaging in the form of MRI or ultrasound imaging is often needed to differentiate between peroneal tendonitis (tendinosis and/or tenosysnovitis), tears, and subluxation. MRI has the advantages of supplying information about a wide array of related and concomitant conditions and being useful for pre-operative planning. In contrast, US is a less time consuming and less costly exam which provides equivalent diagnostic accuracy for tears and is superior in the detection of tendon subluxation. Both modalities are capable of providing information about the presence of the anatomic variants including low-lying peroneus brevis muscle belly, os peroneum, peroneus quartus, and hypertrophied peroneal tubercle.

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References

  1. Lamm BM, Myers DT, Dombek M, Mendicino RW, Catanzariti AR, Saltrick K. Magnetic resonance imaging and surgical correlation of peroneus brevis tears. J Foot Ankle Surg. 2004;43(1):30–6. https://doi.org/10.1053/j.jfas.2003.11.002.

    Article  PubMed  Google Scholar 

  2. Khoury NJ, el-Khoury GY, Saltzman CL, Kathol MH. Peroneus longus and brevis tendon tears: MR imaging evaluation. Radiology. 1996;200(3):833–41.

    Article  CAS  Google Scholar 

  3. Park HJ, Lee SY, Park NH, Rho MH, Chung EC, Kwag HJ. Accuracy of MR findings in characterizing peroneal tendons disorders in comparison with surgery. Acta Radiol. 2012;53(7):795–801. https://doi.org/10.1258/ar.2012.120184.

    Article  PubMed  Google Scholar 

  4. Waitches GM, Rockett M, Brage M, Sudakoff G. Ultrasonographic-surgical correlation of ankle tendon tears. J Ultrasound Med. 1998;17(4):249–56.

    Article  CAS  Google Scholar 

  5. Grant TH, Kelikian AS, Jereb SE, McCarthy RJ. Ultrasound diagnosis of peroneal tendon tears. A surgical correlation. J Bone Joint Surg Am. 2005;87(8):1788–94. https://doi.org/10.2106/JBJS.D.02450.

    Article  PubMed  Google Scholar 

  6. Lee SJ, Jacobson JA, Kim SM, et al. Ultrasound and MRI of the peroneal tendons and associated pathology. Skelet Radiol. 2013;42(9):1191–200. https://doi.org/10.1007/s00256-013-1631-6.

    Article  Google Scholar 

  7. Bianchi S, Delmi M, Molini L. Ultrasound of peroneal tendons. Semin Musculoskelet Radiol. 2010;14(3):292–306. https://doi.org/10.1055/s-0030-1254519.

    Article  PubMed  Google Scholar 

  8. Klauser AS, Peetrons P. Developments in musculoskeletal ultrasound and clinical applications. Skelet Radiol. 2010;39(11):1061–71. https://doi.org/10.1007/s00256-009-0782-y.

    Article  Google Scholar 

  9. Brandes CB, Smith RW. Characterization of patients with primary peroneus longus tendinopathy: a review of twenty-two cases. Foot Ankle Int. 2000;21(6):462–8. https://doi.org/10.1177/107110070002100602.

    Article  CAS  PubMed  Google Scholar 

  10. Saltzman CL, el-Khoury GY. The hindfoot alignment view. [see comment]. Foot Ankle Int. 1995;16(9):572–6.

    Article  CAS  Google Scholar 

  11. Schubert R. MRI of peroneal tendinopathies resulting from trauma or overuse. Br J Radiol. 2013;86(1021):20110750. https://doi.org/10.1259/bjr.20110750.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Wang XT, Rosenberg ZS, Mechlin MB, Schweitzer ME. Normal variants and diseases of the peroneal tendons and superior peroneal retinaculum: MR imaging features. Radiographics. 2005;25(3):587–602. https://doi.org/10.1148/rg.253045123.

    Article  PubMed  Google Scholar 

  13. Mengiardi B, Pfirrmann CW, Schottle PB, et al. Magic angle effect in MR imaging of ankle tendons: influence of foot positioning on prevalence and site in asymptomatic subjects and cadaveric tendons. Eur Radiol. 2006;16(10):2197–206. https://doi.org/10.1007/s00330-006-0164-y.

    Article  PubMed  Google Scholar 

  14. Demondion X, Canella C, Moraux A, Cohen M, Bry R, Cotten A. Retinacular disorders of the ankle and foot. Semin Musculoskelet Radiol. 2010;14(3):281–91. https://doi.org/10.1055/s-0030-1254518.

    Article  PubMed  Google Scholar 

  15. Taljanovic MS, Gimber LH, Becker GW, et al. Shear-wave elastography: basic physics and musculoskeletal applications. Radiographics. 2017;37(3):855–70. https://doi.org/10.1148/rg.2017160116.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Taljanovic MS, Melville DM, Klauser AS, et al. Advances in lower extremity ultrasound. Curr Radiol Rep. 2015;3(6):1–12.

    Article  Google Scholar 

  17. DiGiovanni BF, Fraga CJ, Cohen BE, Shereff MJ. Associated injuries found in chronic lateral ankle instability. Foot Ankle Int. 2000;21(10):809–15.

    Article  CAS  Google Scholar 

  18. Kijowski R, De Smet A, Mukharjee R. Magnetic resonance imaging findings in patients with peroneal tendinopathy and peroneal tenosynovitis. Skelet Radiol. 2007;36(2):105–14. https://doi.org/10.1007/s00256-006-0172-7.

    Article  Google Scholar 

  19. Saupe N, Mengiardi B, Pfirrmann CW, Vienne P, Seifert B, Zanetti M. Anatomic variants associated with peroneal tendon disorders: MR imaging findings in volunteers with asymptomatic ankles. Radiology. 2007;242(2):509–17. https://doi.org/10.1148/radiol.2422051993.

    Article  PubMed  Google Scholar 

  20. Wang CC, Wang SJ, Lien SB, Lin LC. A new peroneal tendon rerouting method to treat recurrent dislocation of peroneal tendons. Am J Sports Med. 2009;37(3):552–7. https://doi.org/10.1177/0363546508325924.

    Article  CAS  PubMed  Google Scholar 

  21. Bencardino JT, Rosenberg ZS, Serrano LF. MR imaging features of diseases of the peroneal tendons. Magn Reson Imaging Clin N Am. 2001;9(3):493–505, x.

    CAS  PubMed  Google Scholar 

  22. Mota J, Rosenberg ZS. Magnetic resonance imaging of the peroneal tendons. Top Magn Reson Imaging. 1998;9(5):273–85.

    Article  CAS  Google Scholar 

  23. Bruce WD, Christofersen MR, Phillips DL. Stenosing tenosynovitis and impingement of the peroneal tendons associated with hypertrophy of the peroneal tubercle. Foot Ankle Int. 1999;20(7):464–7. https://doi.org/10.1177/107110079902000713.

    Article  CAS  PubMed  Google Scholar 

  24. Taki K, Yamazaki S, Majima T, Ohura H, Minami A. Bilateral stenosing tenosynovitis of the peroneus longus tendon associated with hypertrophied peroneal tubercle in a junior soccer player: a case report. Foot Ankle Int. 2007;28(1):129–32. https://doi.org/10.3113/FAI.2007.0022.

    Article  PubMed  Google Scholar 

  25. Sobel M, Bohne WH, Levy ME. Longitudinal attrition of the peroneus brevis tendon in the fibular groove: an anatomic study. Foot Ankle. 1990;11(3):124–8.

    Article  CAS  Google Scholar 

  26. Squires N, Myerson MS, Gamba C. Surgical treatment of peroneal tendon tears. Foot Ankle Clin. 2007;12(4):675–95, vii. https://doi.org/10.1016/j.fcl.2007.08.002.

    Article  PubMed  Google Scholar 

  27. Sobel M, Geppert MJ, Olson EJ, Bohne WH, Arnoczky SP. The dynamics of peroneus brevis tendon splits: a proposed mechanism, technique of diagnosis, and classification of injury. Foot Ankle. 1992;13(7):413–22.

    Article  CAS  Google Scholar 

  28. O’Donnell P, Saifuddin A. Cuboid oedema due to peroneus longus tendinopathy: a report of four cases. Skelet Radiol. 2005;34(7):381–8. https://doi.org/10.1007/s00256-005-0907-x.

    Article  Google Scholar 

  29. Butler BW, Lanthier J, Wertheimer SJ. Subluxing peroneals: a review of the literature and case report. J Foot Ankle Surg. 1993;32(2):134–9.

    CAS  PubMed  Google Scholar 

  30. Oden RR. Tendon injuries about the ankle resulting from skiing. Clin Orthop Relat Res. 1987;216:63–9.

    Google Scholar 

  31. Magnano GM, Occhi M, Di Stadio M, Toma P, Derchi LE. High-resolution US of non-traumatic recurrent dislocation of the peroneal tendons: a case report. Pediatr Radiol. 1998;28(6):476–7. https://doi.org/10.1007/s002470050388.

    Article  CAS  PubMed  Google Scholar 

  32. Eckert WR, Davis EA Jr. Acute rupture of the peroneal retinaculum. J Bone Joint Surg Am. 1976;58(5):670–2.

    Article  CAS  Google Scholar 

  33. Neustadter J, Raikin SM, Nazarian LN. Dynamic sonographic evaluation of peroneal tendon subluxation. AJR Am J Roentgenol. 2004;183(4):985–8. https://doi.org/10.2214/ajr.183.4.1830985.

    Article  PubMed  Google Scholar 

  34. Raikin SM. Intrasheath subluxation of the peroneal tendons. Surgical technique. J Bone Joint Surg Am. 2009;91(Suppl 2 Pt 1):146–55. https://doi.org/10.2106/jbjs.h.01356.

    Article  PubMed  Google Scholar 

  35. Raikin SM, Elias I, Nazarian LN. Intrasheath subluxation of the peroneal tendons. J Bone Joint Surg Am. 2008;90(5):992–9. https://doi.org/10.2106/jbjs.g.00801.

    Article  PubMed  Google Scholar 

  36. Muehleman C, Williams J, Bareither ML. A radiologic and histologic study of the os peroneum: prevalence, morphology, and relationship to degenerative joint disease of the foot and ankle in a cadaveric sample. Clin Anat. 2009;22(6):747–54. https://doi.org/10.1002/ca.20830.

    Article  CAS  PubMed  Google Scholar 

  37. Bashir WA, Lewis S, Cullen N, Connell DA. Os peroneum friction syndrome complicated by sesamoid fatigue fracture: a new radiological diagnosis? Case report and literature review. Skelet Radiol. 2009;38(2):181–6. https://doi.org/10.1007/s00256-008-0588-3.

    Article  Google Scholar 

  38. Sobel M, Pavlov H, Geppert MJ, Thompson FM, DiCarlo EF, Davis WH. Painful os peroneum syndrome: a spectrum of conditions responsible for plantar lateral foot pain. Foot Ankle Int. 1994;15(3):112–24. https://doi.org/10.1177/107110079401500306.

    Article  CAS  PubMed  Google Scholar 

  39. Cheung YY, Rosenberg ZS, Ramsinghani R, Beltran J, Jahss MH. Peroneus quartus muscle: MR imaging features. Radiology. 1997;202(3):745–50. https://doi.org/10.1148/radiology.202.3.9051029.

    Article  CAS  PubMed  Google Scholar 

  40. Sobel M, Levy ME, Bohne WH. Congenital variations of the peroneus quartus muscle: an anatomic study. Foot Ankle. 1990;11(2):81–9.

    Article  CAS  Google Scholar 

  41. Griffith, James F. An introduction to musculoskeletal ultraound. In. Rotations in Radiology- Musculoskeletal Imaging Volume 2 Metabolic, Infectious, and Congenital Diseases; Internal Derangement of the Joints; and Arthrography and Ultrasound In: Mihra ST, Imran MO, Kevin BH, and Tyson SC, editors. Musculoskeletal imaging, rotations in radiology. New York: Oxford University Press; 2019. p. 329–40. https://global.oup.com/academic/product/musculoskeletal-imaging-volume-2-9780190938178?lang=en&cc=us#.

  42. Geller J, Lin S, Cordas D, Vieira P. Relationship of a low-lying muscle belly to tears of the peroneus brevis tendon. Am J Orthop (Belle Mead NJ). 2003;32(11):541–4.

    Google Scholar 

  43. Mirmiran R, Squire C, Wassell D. Prevalence and role of a low-lying peroneus brevis muscle belly in patients with peroneal tendon pathologic features: a potential source of tendon subluxation. J Foot Ankle Surg. 2015;54(5):872–5. https://doi.org/10.1053/j.jfas.2015.02.012.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Freccero DM, Berkowitz MJ. The relationship between tears of the peroneus brevis tendon and the distal extent of its muscle belly: an MRI study. Foot Ankle Int. 2006;27(4):236–9.

    Article  Google Scholar 

  45. Hyer CF, Dawson JM, Philbin TM, Berlet GC, Lee TH. The peroneal tubercle: description, classification, and relevance to peroneus longus tendon pathology. Foot Ankle Int. 2005;26(11):947–50.

    Article  Google Scholar 

  46. Rosenberg ZS, Bencardino J, Astion D, Schweitzer ME, Rokito A, Sheskier S. MRI features of chronic injuries of the superior peroneal retinaculum. AJR Am J Roentgenol. 2003;181(6):1551–7. https://doi.org/10.2214/ajr.181.6.1811551.

    Article  PubMed  Google Scholar 

  47. Ozbag D, Gumusalan Y, Uzel M, Cetinus E. Morphometrical features of the human malleolar groove. Foot Ankle Int. 2008;29(1):77–81. https://doi.org/10.3113/fai.2008.0077.

    Article  PubMed  Google Scholar 

  48. Adachi N, Fukuhara K, Kobayashi T, Nakasa T, Ochi M. Morphologic variations of the fibular malleolar groove with recurrent dislocation of the peroneal tendons. Foot Ankle Int. 2009;30(6):540–4. https://doi.org/10.3113/fai.2009.0540.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Arizona College of Medicine, Tucson, AZ, USA

    L. Daniel Latt

  2. Department of Medical Imaging, University of Arizona College of Medicine, Tucson, AZ, USA

    Gokhan Kuyumcu & Mihra S. Taljanovic

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  1. L. Daniel Latt
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  2. Gokhan Kuyumcu
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Correspondence to L. Daniel Latt .

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  1. Private Practice, Atlantic Highlands, NJ, USA

    Mark Sobel

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Latt, L.D., Kuyumcu, G., Taljanovic, M.S. (2020). High-Resolution Ultrasound and MRI Imaging of Peroneal Tendon Injuries. In: Sobel, M. (eds) The Peroneal Tendons. Springer, Cham. https://doi.org/10.1007/978-3-030-46646-6_5

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  • DOI: https://doi.org/10.1007/978-3-030-46646-6_5

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