Radiological features accompanying peroneus brevis split rupture revealed on magnetic resonance imaging – a cohort study

Abstract

Background Peroneal split tears are an underrated cause of ankle pain. While magnetic resonance imaging (MRI) is useful for diagnosis, split tears are challenging to identify. The aim of the study was to investigate the association of peroneus brevis split rupture with abnormalities of the superior peroneal retinaculum (SPR), anterior talofibular ligament (ATFL), calcaneofibular ligament (CFL), joint effusion, morphology of the malleolar groove, presence of the bone marrow oedema and prominent peroneal tuberculum. Methods Ankle MRI cases were assessed by independent observers retrospectively in two groups: one with peroneus brevis split tears (n = 80) and one without (control group, n = 115). Two observers evaluated the soft tissue lesions, and three graded the bone lesions. Fisher’s exact test and Pearson correlation were used for analysis. The Bonferroni-Holm method (B-H) was used to adjust for multiple comparisons. Results Only bone marrow edema in the posterior part of the lateral malleolus was significantly (p < 0.05) more common in the split tear group after applying B-H. SPR total rupture was seen only in the experimental group. No differences in incidence of ATFL and CFL lesions or other SPR lesions were noticed (p < 0.05). Conclusion Bone marrow edema in the posterior part of the lateral malleolus is associated with peroneus split tears on MRI.

Comparison of Ultrasound and MRI with Intraoperative Findings in the Diagnosis of Peroneal Tendinopathy, Tears, and Subluxation

“…This could explain why peroneus brevis tendon tears are somewhat better evaluated using MRI. Furthermore, MRI affords a better visualization of predisposing osseous anatomy, such as a prominent peroneal tubercle or convex fibular groove, or the presence of associated lateral malleolar bone marrow edema [28,29], while predisposing anatomic variants, such as a low-lying peroneus brevis or a peroneus quartus, may be seen at both MRI and US [28,30].…”