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Musculoskeletal Imaging

Peroneal tendon

1. Anatomy

one of two tendons (of the peroneus brevis muscle and peroneus longus muscle) that are important stabilizers of the ankle joint. Also, see tendon of peroneus longus muscle and tendon of peroneus brevis muscle.

2. Pathology

An intimate relationship of the common peroneal tendon sheath and the calcaneofibular ligament may result in opacification of the sheath on arthrography after injuries to the ankle joint.

Traumatic dislocations of the peroneal tendons may be associated with disruption of the superior peroneal retinaculum, such as occurs after inversion at the ankle with the foot in a position of plantar flexion. On routine radiography a small avulsion fracture is sometimes noted adjacent to the lateral surface of the lateral malleolus. Other imaging techniques allowing identification of subluxation or dislocation of the peroneal tendons are peroneal tenography, ultrasonography, CT scanning and MR imaging.

After fractures of the calcaneus, the lateral wall of the bone may become displaced laterally, resulting in narrowing of the fibulocalcaneal space, which may or may not be accompanied by entrapment of the peroneal tendons between the fibula, calcaneus, and talus or by subluxation or dislocation of the peroneal tendons.

Inflammation in the peroneal tendons or their sheath usually results from acute injury or chronic stress. Ultrasonography, peroneal tenography and MR imaging can be used in the evaluation of inflammation of the peroneal tendons and sheath.

Partial or complete disruption of one or both peroneal tendons can occur spontaneously or may accompany an acute injury. Ruptures of the peroneus longus tendon may lead to a fracture or a change in position of the os peroneum. MR imaging allows identification of abnormal signal intensity or size of the tendon. Ruptures of the peroneus brevis tendon may lead to peroneal split syndrome.

Stenosing tenosynovitis of the tendon sheath of the peroneal tendons may occur in three locations: posterior to the lateral malleolus, at the peroneal trochlea and at the plantar surface of the calcaneus.

DR