Semin Musculoskelet Radiol 2010; 14(3): 292-306
DOI: 10.1055/s-0030-1254519
© Thieme Medical Publishers

Ultrasound of Peroneal Tendons

Stefano Bianchi1 , Marino Delmi2 , Lucio Molini3
  • 1CIM Cabinet Imagerie Medicale, Genève–CH, Switzerland
  • 2Foot and Ankle Center, Clinique des Grangettes, Genève–CH, Switzerland
  • 3S.C. Radiodiagnostica, Ospedale Galliera, Genova, Italy
Further Information

Publication History

Publication Date:
10 June 2010 (online)

ABSTRACT

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.

REFERENCES

  • 1 Heckman D S, Gluck G S, Parekh S G. Tendon disorders of the foot and ankle, part 1: peroneal tendon disorders.  Am J Sports Med. 2009;  37(3) 614-625
  • 2 Philbin T M, Landis G S, Smith B. Peroneal tendon injuries.  J Am Acad Orthop Surg. 2009;  17(5) 306-317
  • 3 Selmani E, Gjata V, Gjika E. Current concepts review: peroneal tendon disorders.  Foot Ankle Int. 2006;  27(3) 221-228
  • 4 Trevino S, Baumhauer J F. Tendon injuries of the foot and ankle.  Clin Sports Med. 1992;  11(4) 727-739
  • 5 Saupe N, Mengiardi B, Pfirrmann C W, Vienne P, Seifert B, Zanetti M. Anatomic variants associated with peroneal tendon disorders: MR imaging findings in volunteers with asymptomatic ankles.  Radiology. 2007;  242(2) 509-517
  • 6 Numkarunarunrote N, Malik A, Aguiar R O, Trudell D J, Resnick D. Retinacula of the foot and ankle: MRI with anatomic correlation in cadavers.  AJR Am J Roentgenol. 2007;  188(4) W348–54
  • 7 Ruiz J R, Christman R A, Hillstrom H J. 1993 William J. Stickel Silver Award. Anatomical considerations of the peroneal tubercle.  J Am Podiatr Med Assoc. 1993;  83(10) 563-575
  • 8 Bianchi S, Martinoli C, Gaignot C, De Gautard R, Meyer J M. Ultrasound of the ankle: anatomy of the tendons, bursae, and ligaments.  Semin Musculoskelet Radiol. 2005;  9(3) 243-259
  • 9 Hyer C F, Dawson J M, Philbin T M, Berlet G C, Lee T H. The peroneal tubercle: description, classification, and relevance to peroneus longus tendon pathology.  Foot Ankle Int. 2005;  26(11) 947-950
  • 10 Wang X T, Rosenberg Z S, Mechlin M B, Schweitzer M E. Normal variants and diseases of the peroneal tendons and superior peroneal retinaculum: MR imaging features.  Radiographics. 2005;  25(3) 587-602
  • 11 Sookur P A, Naraghi A M, Bleakney R R, Jalan R, Chan O, White L M. Accessory muscles: anatomy, symptoms, and radiologic evaluation.  Radiographics. 2008;  28(2) 481-499
  • 12 Sobel M, Levy M E, Bohne W HO. Congenital variations of the peroneus quartus muscle: an anatomic study.  Foot Ankle. 1990;  11(2) 81-89
  • 13 Sobel M, Geppert M J, Olson E J, Bohne W H, Arnoczky S P. The dynamics of peroneus brevis tendon splits: a proposed mechanism, technique of diagnosis, and classification of injury.  Foot Ankle. 1992;  13(7) 413-422
  • 14 Chepuri N B, Jacobson J A, Fessell D P, Hayes C W. Sonographic appearance of the peroneus quartus muscle: correlation with MR imaging appearance in seven patients.  Radiology. 2001;  218(2) 415-419
  • 15 Cheung Y Y, Rosenberg Z S, Ramsinghani R, Beltran J, Jahss M H. Peroneus quartus muscle: MR imaging features.  Radiology. 1997;  202(3) 745-750
  • 16 Mick C A, Lynch F. Reconstruction of the peroneal retinaculum using the peroneus quartus. A case report.  J Bone Joint Surg Am. 1987;  69(2) 296-297
  • 17 Sammarco G J. Peroneal tendon injuries.  Orthop Clin North Am. 1994;  25(1) 135-145
  • 18 Sobel M, Pavlov H, Geppert M J, Thompson F M, DiCarlo E F, Davis W H. Painful os peroneum syndrome: a spectrum of conditions responsible for plantar lateral foot pain.  Foot Ankle Int. 1994;  15(3) 112-124
  • 19 Peacock K C, Resnick E J, Thoder J J. Fracture of the os peroneum with rupture of the peroneus longus tendon. A case report and review of the literature.  Clin Orthop Relat Res. 1986;  202(202) 223-226
  • 20 Bessette B J, Hodge J C. Diagnosis of the acute os peroneum fracture.  Singapore Med J. 1998;  39(7) 326-327
  • 21 Rivard D S, Sobiesk G, Wertheimer S J. Bilateral congenital peroneal tendon subluxation.  J Foot Ankle Surg. 1998;  37(4) 339-344
  • 22 Maffulli N, Ferran N A, Oliva F, Testa V. Recurrent subluxation of the peroneal tendons.  Am J Sports Med. 2006;  34(6) 986-992
  • 23 Neustadter J, Raikin S M, Nazarian L N. Dynamic sonographic evaluation of peroneal tendon subluxation.  AJR Am J Roentgenol. 2004;  183(4) 985-988
  • 24 Ohashi K, Restrepo J M, El-Khoury G Y, Berbaum K S. Peroneal tendon subluxation and dislocation: detection on volume-rendered images—initial experience.  Radiology. 2007;  242(1) 252-257
  • 25 Magnano G M, Occhi M, Di Stadio M, Toma' P, Derchi L E. High-resolution US of non-traumatic recurrent dislocation of the peroneal tendons: a case report.  Pediatr Radiol. 1998;  28(6) 476-477
  • 26 Raikin S M, Elias I, Nazarian L N. Intrasheath subluxation of the peroneal tendons.  J Bone Joint Surg Am. 2008;  90(5) 992-999
  • 27 McConkey J P, Favero K J. Subluxation of the peroneal tendons within the peroneal tendon sheath. A case report.  Am J Sports Med. 1987;  15(5) 511-513
  • 28 Oden R R. Tendon injuries about the ankle resulting from skiing.  Clin Orthop Relat Res. 1987;  216(216) 63-69
  • 29 Khoury V, Cardinal E, Bureau N J. Musculoskeletal sonography: a dynamic tool for usual and unusual disorders.  AJR Am J Roentgenol. 2007;  188(1) W63–73
  • 30 Smania L, Craig J G, von Holsbeeck M. Ultrasonographic findings in peroneus longus tendon rupture.  J Ultrasound Med. 2007;  26(2) 243-246
  • 31 Grant T H, Kelikian A S, Jereb S E, McCarthy R J. Ultrasound diagnosis of peroneal tendon tears. A surgical correlation.  J Bone Joint Surg Am. 2005;  87(8) 1788-1794
  • 32 Dombek M F, Lamm B M, Saltrick K, Mendicino R W, Catanzariti A R. Peroneal tendon tears: a retrospective review.  J Foot Ankle Surg. 2003;  42(5) 250-258
  • 33 Rademaker J, Rosenberg Z S, Delfaut E M, Cheung Y Y, Schweitzer M E. Tear of the peroneus longus tendon: MR imaging features in nine patients.  Radiology. 2000;  214(3) 700-704
  • 34 Brigido M K, Fessell D P, Jacobson J A et al.. Radiography and US of os peroneum fractures and associated peroneal tendon injuries: initial experience.  Radiology. 2005;  237(1) 235-241
  • 35 Bianchi S, Abdelwahab I F, Tegaldo G. Fracture and posterior dislocation of the os peroneum associated with rupture of the peroneus longus tendon.  Can Assoc Radiol J. 1991;  42(5) 340-344
  • 36 Peterson J J, Bancroft L W. Os peroneal fracture with associated peroneus longus tendinopathy.  AJR Am J Roentgenol. 2001;  177(1) 257-258
  • 37 Diaz G C, van Holsbeeck M, Jacobson J A. Longitudinal split of the peroneus longus and peroneus brevis tendons with disruption of the superior peroneal retinaculum.  J Ultrasound Med. 1998;  17(8) 525-529
  • 38 Krause J O, Brodsky J W. Peroneus brevis tendon tears: pathophysiology, surgical reconstruction, and clinical results.  Foot Ankle Int. 1998;  19(5) 271-279
  • 39 Sobel M, Geppert M J, Olson E J, Bohne W H, Arnoczky S P. The dynamics of peroneus brevis tendon splits: a proposed mechanism, technique of diagnosis, and classification of injury.  Foot Ankle. 1992;  13(7) 413-422
  • 40 Taki K, Yamazaki S, Majima T, Ohura H, Minami A. Bilateral stenosing tenosynovitis of the peroneus longus tendon associated with hypertrophied peroneal tubercle in a junior soccer player: a case report.  Foot Ankle Int. 2007;  28(1) 129-132
  • 41 Bruce W D, Christofersen M R, Phillips D L. Stenosing tenosynovitis and impingement of the peroneal tendons associated with hypertrophy of the peroneal tubercle.  Foot Ankle Int. 1999;  20(7) 464-467
  • 42 Vinson E N, Dodd L G, Merian M, Martinez S. Synovial lipomatosis arborescens of the peroneal tendon sheath.  Skeletal Radiol. 2008;  37(10) 947-950
  • 43 Huang G S, Lee H S, Hsu Y C, Kao H W, Lee H H, Chen C Y. Tenosynovial lipoma arborescens of the ankle in a child.  Skeletal Radiol. 2006;  35(4) 244-247

Stefano BianchiM.D. 

Route de Florissant 70, 1206-Geneva–CH

Switzerland

Email: stefanobianchi@bluewin.ch

    >