Peroneal tendon bupivacaine injection: utility of concomitant injection of contrast material

Twenty patients received the installation of contrast material into the peroneal tendons while local anesthetic was injected as a diagnostic test. In three patients (15%), communication with the ankle joint and subtalar joint was noted, as well as failure of the contrast to fill the distal tendon. Injection of local anesthetic into the peroneal tendons as a diagnostic measure, therefore, may not have 100% sensitivity of specificity. Simultaneous injection of contrast material can be used to alert the clinician to a lack of specificity of the anesthetic test injection.