Asymptomatic peroneal tendon pathology

NewsBot · Mar 4, 2016

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Peroneal Tendon Abnormalities on Routine Magnetic Resonance Imaging of the Foot and Ankle
Joseph T. O?Neil et al
Foot & Ankle International March 3, 2016 107110071663564

Background: Abnormalities of the peroneal tendons can frequently be identified on routine MRI of the foot and ankle. Previous studies in the orthopedic literature have discussed the prevalence of abnormal MRI findings in asymptomatic patients, most notably with regards to the spine and shoulder. The purpose of this study was to determine the prevalence of abnormal findings of the peroneal tendons on MRI in asymptomatic individuals.
Methods: We retrospectively reviewed all foot and ankle MRIs from 2 independent time periods that were either performed or reviewed at our institution. Studies were excluded if performed on patients with documented inversion injuries, ankle sprains, or lateral ankle trauma. A total of 294 (of 617) MRIs were eligible for inclusion in this study. A single attending musculoskeletal radiologist reviewed each MRI. Pathologies of the peroneal tendons included tendinosis, tenosynovitis, acute tears, chronic tears, and tendon splits. Additionally, the primary pathology encountered on each MRI was noted. The mean age of the MRIs included in this study was 46.8 years (range 9-82) with 155 females and 139 males.
Results: The most commonly occurring primary pathology was Achilles tendinosis/tears (86), followed by posterior tibial tendon dysfunction (43). With regards to the peroneal tendons, 103 of the 294 (35%) MRIs demonstrated some pathology.
Conclusion: The results of this study demonstrated that a sizeable percentage of asymptomatic individuals could have peroneal tendon pathology on MRI of the foot and ankle. This study can have important clinical implications for when patients present with concerning MRI findings that do not correlate clinically. Physicians providing musculoskeletal care can counsel and reassure patients who present with peroneal pathology on MRI but an absence of clinical findings.
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Admin2 · Mar 4, 2016

Related Topics:
Peroneal Tendon Dysfunction
Peroneus Longus Tear
Anatomic variants and peroneal tendon disorders
Peroneal Subluxation
Peroneal tendinosis and ankle sprains
Function of the peroneal tendons

NewsBot · Aug 28, 2020

Peroneal Sheath Volumes Are Greater in Patients With Peroneal Pathology Compared With Controls
Christopher P Miller et al
Foot Ankle Spec. 2020 Aug 27

Background: Peroneal tendon pathology is common. Several factors have been implicated, including low-lying muscles and accessory tendons. Studies have reported on the presence and length measurements of these structures. This study evaluates volume measurements within the sheath using magnetic resonance images for patients with operatively treated peroneal tendon pathology and control patients without peroneal disease.

Methods: Fifty-one patients with peroneal tendon pathology and 15 controls were included. The volumes of the peroneal sheath, peroneal tendons, peroneal muscle, and accessory peroneus tendons were measured. The distal extent of the peroneus brevis (PB) muscle was measured. Volume and length measurements were then compared.

Results: The mean PB muscle length from the tip of the fibula was 5.55 ± 2.5 mm (peroneal group) and 11.79 ± 4.07 mm (control) (P = .017). The mean peroneal sheath volume was 7.06 versus 5.12 mL, respectively (P = .001). The major contributors to this increased volume was the tenosynovitis (3.58 vs 2.56 mL, respectively; P = .019), the peroneal tendons (2.17 vs 1.7 mL, P = .004), and the accessory peroneus tendon + PB muscle (1.31 vs 0.86 mL, P = .023).

Conclusion: The current study supports that the PB muscle belly is more distal in patients with peroneal tendon pathology. The study also demonstrates increased total volume within the peroneal sheath among the same patients. We propose that increased volume within the sheath, regardless of what structure is enlarged, is associated with peroneal tendon pathology. Further studies are needed to determine if debridement and decompression of the sheath will result in improved functional outcomes for these patients.
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