Ultrasound of peroneal tendons

Disorders of the peroneal tendon (PeT) complex are common and affect patients of many different ages. They can be traumatic, inflammatory, infective, or degenerative. Clinical assessment orients the diagnosis, but an imaging modality is almost always performed to confirm the clinical impression and to obtain additional information that is essential in choosing among different treatments. Due to its peculiar characteristics of high resolution, cost effectiveness, noninvasiveness, and dynamism, ultrasound (US) is now widely considered the first-line imaging modality to assess superficial tendons. US not only allows an optimal evaluation of the PeT complex but can also accurately assess its synovial sheath, retinacula, and adjacent tissues. This article describes the normal anatomy, technique of examination, and normal US anatomy of the PeT complex as well as illustrating the US appearance of its main disorders.