Abstract:MRI findings of chronic peroneal tendon pathology are diagnostically specific but not sensitive. MRI showed high sensitivity for diagnosing tendon swelling in the peroneus longus, but not in the peroneus brevis. MRI is sensitive but not specific for detecting negative findings.
“…These results are comparable to the Park et al 32 MRI study on 82 patients, in which 14 peroneal tendon tears were identified preoperatively, and 11 were confirmed during surgery, with a sensitivity of 54.5%, specificity of 88.7%, and accuracy of 84.1%. The Park et al 33 MRI study on 97 patients with chronic lateral ankle pain concluded that MRI is specific but not sensitive in diagnosing peroneal tendon pathology, also confirmed by our results.…”
Background: We hypothesized that peroneal tendons disorders are more commonly associated with anatomical variations, which could overcrowd the retrofibular groove. Methods: This single-center retrospective case study covered 84 consecutive cases that had undergone peroneal tendoscopy. Peroneal tendoscopy was performed on 82 patients, predominantly female (3:1) with a median age of 46 years. The preoperative evaluation and all the procedures were performed by a single surgeon using a standardized technique. Results: Two patients required revision surgery 8 and 52 months after the index procedure due to persistent posterolateral ankle pain. Peroneal tendoscopy was performed as a solitary procedure in 45.1% (37/82) of cases, while the remaining cases involved peroneal tendoscopy as a supplementary procedure. Low-lying peroneus brevis muscle belly (LLMB) was the most common finding in this series in 53.7% (44/82) of cases. In 41.5% (34/82) of cases, longitudinal tears of the peroneus brevis tendon were noted. Some patients presented with more than 1 concomitant peroneal tendon pathology. The LLMB was observed in 23.5% (8/34) of cases with a longitudinal tear of the peroneus brevis tendon. Conclusion: Peroneal tendon anatomical variations, especially LLMB, were associated with the presence of peroneus brevis tendon ruptures and intrasheath peroneal tendon subluxations as well as posttraumatic posterolateral ankle pain. Due to high rates of undiagnosed and misdiagnosed cases of LLMB preoperatively, we believe special care should be taken to recognize it during tendoscopy. Peroneal tendoscopy is a high-efficiency, low-complication method to treat some peroneal tendon conditions. Level of Evidence: Level IV, case series.
“…These results are comparable to the Park et al 32 MRI study on 82 patients, in which 14 peroneal tendon tears were identified preoperatively, and 11 were confirmed during surgery, with a sensitivity of 54.5%, specificity of 88.7%, and accuracy of 84.1%. The Park et al 33 MRI study on 97 patients with chronic lateral ankle pain concluded that MRI is specific but not sensitive in diagnosing peroneal tendon pathology, also confirmed by our results.…”
Background: We hypothesized that peroneal tendons disorders are more commonly associated with anatomical variations, which could overcrowd the retrofibular groove. Methods: This single-center retrospective case study covered 84 consecutive cases that had undergone peroneal tendoscopy. Peroneal tendoscopy was performed on 82 patients, predominantly female (3:1) with a median age of 46 years. The preoperative evaluation and all the procedures were performed by a single surgeon using a standardized technique. Results: Two patients required revision surgery 8 and 52 months after the index procedure due to persistent posterolateral ankle pain. Peroneal tendoscopy was performed as a solitary procedure in 45.1% (37/82) of cases, while the remaining cases involved peroneal tendoscopy as a supplementary procedure. Low-lying peroneus brevis muscle belly (LLMB) was the most common finding in this series in 53.7% (44/82) of cases. In 41.5% (34/82) of cases, longitudinal tears of the peroneus brevis tendon were noted. Some patients presented with more than 1 concomitant peroneal tendon pathology. The LLMB was observed in 23.5% (8/34) of cases with a longitudinal tear of the peroneus brevis tendon. Conclusion: Peroneal tendon anatomical variations, especially LLMB, were associated with the presence of peroneus brevis tendon ruptures and intrasheath peroneal tendon subluxations as well as posttraumatic posterolateral ankle pain. Due to high rates of undiagnosed and misdiagnosed cases of LLMB preoperatively, we believe special care should be taken to recognize it during tendoscopy. Peroneal tendoscopy is a high-efficiency, low-complication method to treat some peroneal tendon conditions. Level of Evidence: Level IV, case series.
“…MRI remains a sensitive, but not specific, tool for the diagnosis of peroneal tendon pathologies because of the potential for magic angle artifact from the curvature of the peroneal tendons and difficulties encountered when imaging the tendons out of plane. 4,24,25,27,[29][30][31][32] Quantifiable and reliable techniques are needed for earlier clinical diagnosis of peroneal tendon health to support subjective visual interpretation of the images. Recently, quantitative MRI mapping has been applied to the assessment of tendon and ligament tissue.…”
This study provides a quantitative method and normative baseline T2* mapping values for comparison with symptomatic clinically compromised peroneal tendon patients.
“…Significant fluid collection was defined as the presence of circumferential fluid within the common peroneal tendon sheath with a maximal width greater than 3 mm (11). If the tendon showed clefts and defects that extended into the substance of the tendon itself, a tendon split was diagnosed (12). Fig.…”
Peroneal views provide better anatomic evaluation of the peroneal tendons itself, although cannot show significant superiority in the diagnostic performances.
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