An Examination of Anatomic Variants and Incidental Peroneal Tendon Pathologic Features: A Comprehensive MRI Review of Asymptomatic Lateral Ankles

Galli, Melissa M.; Protzman, Nicole M.; Mandelker, Eiran M.; Malhotra, Amit D.; Schwartz, Edward; Brigido, Stephen A.

doi:10.1053/j.jfas.2014.11.005

Cited by 22 publications

(19 citation statements)

References 27 publications

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“…In the study of Galli et al. (31), no statistically significant correlations were observed between the presence of medial-lateral OCLTs and tendinopathy of the peroneus brevis, tears of the peroneus brevis, and tendinopathy of the peroneus longus. Stasko et al.…”

Section: Discussionmentioning

confidence: 82%

MRI evaluation of ligaments and tendons of foot arch in talar dome osteochondral lesions

Koç

Karabıyık

2017

Acta Radiol

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Background There are no publications in literature describing an association between disorders of the ligaments and tendons supporting the foot arch and osteochondral lesions of the talus (OCLT). We believe there may be a correlation between the damage of these structures. Purpose To investigate the pathologies of main ligaments and tendons that support the foot arch in sprained ankles, by reviewing magnetic resonance imaging (MRI) studies and comparing the results in two groups of patients, with and without OCLT. Material and Methods MR images from 316 patients examined in the orthopedic clinic for ankle sprain were evaluated for pathologic findings of the plantar fascia, short and long plantar ligaments, spring ligament, sinus tarsi, and ankle tendons supporting the foot arch. Findings were compared between two groups of patients: 158 patients with OCLT and 158 patients without OCLT. Results Plantar fascia, short plantar ligament, and spring ligament abnormalities were seen in 50 (31.6%), 28 (17.7%), and 60 (38%) patients with OCLT, and in nine (5.6%), three (1.9%), and 18 (11.4%) patients without OCLT, respectively ( P < 0.05). Sinus tarsi and tendon abnormalities were seen in 11 (6.7%) and nine (5.7%) patients with OCLT, and in eight (5%) and eight (5%) patients without OCLT, respectively ( P > 0.05). Two or more associated abnormalities were present in 50 (31.6%) patients with OCLT and in 11 (6.7%) without OCLT ( P < 0.05). Conclusion Plantar fascia, short plantar ligament, and spring ligament abnormalities were commonly seen in patients with OCLT on MRI, while sinus tarsi and tendon abnormalities were not. Concomitant pathologies have an increased incidence in patients with OCLT.

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Section: Discussionmentioning

confidence: 82%

MRI evaluation of ligaments and tendons of foot arch in talar dome osteochondral lesions

Koç

Karabıyık

2017

Acta Radiol

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“…14,17 Our study shows that 57.3% (47/82) of cases involved a particular peroneal tendon anatomical variation, which is surprising if it is known that LLMB can be found in 33% of individuals and that PQ muscle incidence varies from 5% to 16%. 1,3,10,16,47 Most of the cases were due to LLMB, while the PQ muscle has been noted only once.…”

Section: Discussionmentioning

confidence: 99%

Importance of Space-Occupying Anatomical Variations in Peroneal Tendoscopy

2020

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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.

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“…High-resolution magnetic resonance (MR) imaging using 1.5 T and high-resolution ultrasonography (US) with highfrequency linear transducers allow detailed delineation of the anatomy and diseases of the lateral ankle structures, including the SPR (13,14) . Various MR studies have evaluated the appearance of the SPR and variations of the peroneal tendon complex (1,5,(14)(15)(16)(17) . Using MR imaging, interconnections have been reported between the following structures: the anterior talofibular ligament (ATFL), the inferior extensor retinaculum (IER), and the peroneal tendon sheath (PTS), and their association to other common anatomical variations described in the literature (11,12,18,19) .…”

Section: Introductionmentioning

confidence: 99%

Anatomical variations and interconnections of the superior peroneal retinaculum to adjacent lateral ankle structures: a preliminary imaging anatomy study

et al. 2021

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Aim: This imaging anatomy study aimed at detecting anatomical variations and potential interconnections of the superior peroneal retinaculum to other lateral stabilizing structures. Materials and methods: We retrospectively reviewed the imaging archives of 63 patients (38 females, 25 males, mean age 32.7, range 18–58 years) with available ankle US, MR and CT images to detect whether US and MR can detect the presence of interconnections between the superior peroneal retinaculum and the anterior talofibular ligament, inferior extensor retinaculum and peroneal tendon sheath. We evaluated the presence of common anatomical variations including low peroneus brevis muscle belly, peroneal tubercle, os peroneum, and retromalleolar fibular groove shape in relation to the presence of superior peroneal retinaculum connections. Results: The connections of the superior peroneal retinaculum can be revealed on magnetic resonance imaging (MRI) and ultrasound (US). The connection to the anterior talofibular ligament was located (a) inferior to the lateral malleolus, (b) at the level of the lateral malleolus and (c) on both levels, respectively (a) 49.2% on MRI and 39.7% on US, p <0.05, (b) 44.4% and 58.7%, p <0.05, 36.5% and (c) 27%, p <0.05. Superior peroneal retinaculum–inferior extensor retinaculum (MRI 47.6%, US 28.6% p <0.001) and superior peroneal retinaculum–peroneal tendon sheath (MRI 22.2%, US 25.4% p >0.05) connections were also found both on MR and US. Conclusion: Ankle US and MR revealed interconnections between the superior peroneal retinaculum and the anterior talofibular ligament, inferior extensor retinaculum, and superior peroneal retinaculum. Our results are a starting point for further studies on the connections of the superior peroneal retinaculum and the applicability of ultrasound and MRI in assessing their occurrence. Knowledge of the anatomical connections of the superior peroneal retinaculum may help radiologists with the assessment of lateral ankle injuries, and surgeons with treatment planning.

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An Examination of Anatomic Variants and Incidental Peroneal Tendon Pathologic Features: A Comprehensive MRI Review of Asymptomatic Lateral Ankles

Cited by 22 publications

References 27 publications

MRI evaluation of ligaments and tendons of foot arch in talar dome osteochondral lesions

MRI evaluation of ligaments and tendons of foot arch in talar dome osteochondral lesions

Importance of Space-Occupying Anatomical Variations in Peroneal Tendoscopy

Anatomical variations and interconnections of the superior peroneal retinaculum to adjacent lateral ankle structures: a preliminary imaging anatomy study

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