Comparison of Preoperative MRI With Intraoperative Findings for Peroneal Tendon Pathologies

Area of Science:

• Orthopedic Surgery
• Radiology
• Medical Imaging

Background:

• Magnetic resonance imaging (MRI) is a standard tool for foot and ankle soft tissue evaluation.
• Previous studies indicate MRI has limitations in assessing peroneal tendon pathologies.
• Peroneal tendon injuries are common causes of ankle pain and dysfunction.

Purpose of the Study:

• To investigate the correlation between pre-operative MRI findings and intraoperative observations of peroneal tendons.
• To identify specific peroneal tendon pathologies where MRI accuracy is questionable.
• To inform surgical decision-making by clarifying MRI's diagnostic utility in the ankle.

Main Methods:

• Retrospective analysis of 80 ankle MRIs performed before surgery.
• Interpretation of MRIs by five board-certified radiologists.
• Comparison of radiologist interpretations with findings from a single board-certified foot and ankle surgeon during surgery.

Main Results:

• Significant disagreement noted between MRI and surgical findings for peroneus brevis (PB) and peroneus longus (PL) tendons.
• Discrepancies observed in diagnosing normal PB, tendinosis, hypertrophy, partial linear tears, flattening, and longitudinal split tears.
• The study highlighted a statistically significant discordance across the spectrum of PB attritional changes.

Conclusions:

• Pre-operative MRI findings show significant disagreement with intraoperative assessments for various peroneal tendon conditions.
• Radiologists and surgeons exhibit notable differences in interpreting peroneal tendon pathology on MRI.
• Surgeons should exercise caution when relying solely on MRI for evaluating peroneal tendon pathologies in the foot and ankle.