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MR findings in peroneal tendonopathy
L Yao1, D J Tong, A Cracchiolo
1UCLA Department of Radiological Sciences 90024-6952, USA.
Objective:
The purpose of this presentation is to familiarize the reader with the often subtle findings of peroneal tendon derangement on MRI examination.
Materials And Methods:
We present four patients who were studied with MR (1.5 T) prior to surgical exploration of the peroneal tunnel. All patients had lateral ankle symptoms for > 6 months. Normal MR anatomy and an example of the peroneus quartus tendon are also shown.
Results:
Surgery revealed two peroneus brevis and three peroneus longus lesions. A "multipartite" appearance of the peroneus tendon on axial MR images, especially when paired with a "flame-shaped" appearance on more distal axial images, indicates a longitudinal tendon split. Both patients with peroneus brevis tendon splits had insufficient superior peroneal retinacula.
Conclusion:
Partial ruptures of the peroneal tendons characteristically take the form of longitudinal tendon splits. Axial MR images through the ankle and hindfoot can help distinguish peroneal tendonitis from longitudinal tendon splits.
Insights
Subtle MRI findings can reveal peroneal tendon tears, often presenting as longitudinal splits. Axial views are key to differentiating these tears from peroneal tendonitis in lateral ankle pain.
Area of Science:
- Radiology
- Orthopedic Imaging
- Musculoskeletal MRI
Background:
- Peroneal tendon injuries are a common cause of lateral ankle pain.
- Accurate diagnosis is crucial for effective treatment and surgical planning.
Observation:
- This study reviewed MRI scans of four patients with chronic lateral ankle symptoms.
- MR imaging (1.5 T) was performed prior to surgical exploration of the peroneal tunnel.
Findings:
- Longitudinal tendon splits, characterized by a "multipartite" appearance on axial images and "flame-shaped" distal views, indicate peroneal tendon tears.
- Surgery confirmed peroneus brevis and longus tendon lesions in all patients.
- Insufficient superior peroneal retinacula were noted in patients with peroneus brevis tendon splits.
Implications:
- Axial MRI sequences are valuable for distinguishing peroneal tendon splits from tendonitis.
- Understanding these subtle MRI findings improves diagnostic accuracy for peroneal tendon pathology.
- This knowledge aids in surgical decision-making for lateral ankle pain.