American Journal of Roentgenology, Vol 168, 129-133, Copyright © 1997 by American Roentgen Ray Society

ARTICLES

Using MR imaging to differentiate peroneal splits from other peroneal disorders

ME Schweitzer, ME Eid, D Deely, K Wapner and P Hecht
Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.

OBJECTIVE: Peroneal splits syndrome is the result of repetitive subluxations that lead to longitudinal tears of the peroneus brevis tendon. The purpose of this study was to use MR imaging to differentiate the characteristics of peroneal splits syndrome from other peroneal disorders. MATERIALS AND METHODS: Forty-two ankles in 39 patients (age range, 10-70 years old) clinically diagnosed with peroneal tendon disorders were studied with 1.5-T MR imaging. Two independent, blinded observers evaluated the peroneal tendons in these 42 ankles for evidence of altered morphology, increased intratendon signal intensity on T2-weighted images, volume of fluid within the peroneal tendon sheath, shape of the fibular peroneal groove, sharp posterolateral margin of the distal fibula, and subluxation or dislocation at the time of imaging. Surgical-clinical correlation provided the diagnosis. RESULTS: Peroneal splits were confirmed at surgery in 20 ankles. The MR findings were bisected peroneus brevis tendon (p < .0001), convex or flat fibular groove (p = .03), and spur on the edge of the groove (p = .002). Increased fluid in the peroneal tendon sheath was seen in only 55% (p = .099) of these ankles, and hypertrophied peroneus longus tendon was seen in only 15%. Increased intratendon signal intensity on T2-weighted sequences within either the peroneus brevis tendon or the peroneus longus tendon was seen in patients with peroneal splits (60%) (p = .296) as often as in patients without peroneal splits (59%). Subluxation was slightly more common in patients with peroneal splits (25%) than in patients without (18%). CONCLUSION: Peroneal splits syndrome shows with a high frequency a bisected peroneus brevis tendon, a convex or flat fibular groove, and a posterolateral marrow-containing fibular spur.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				N. Numkarunarunrote, A. Malik, R. O. Aguiar, D. J. Trudell, and D. Resnick Retinacula of the Foot and Ankle: MRI with Anatomic Correlation in Cadavers Am. J. Roentgenol., April 1, 2007; 188(4): W348 - W354. [Abstract] [Full Text] [PDF]

				T. H. Grant, A. S. Kelikian, S. E. Jereb, and R. J. McCarthy Ultrasound Diagnosis of Peroneal Tendon Tears. A Surgical Correlation J. Bone Joint Surg. Am., August 1, 2005; 87(8): 1788 - 1794. [Abstract] [Full Text] [PDF]

				X.-T. Wang, Z. S. Rosenberg, M. B. Mechlin, and M. E. Schweitzer Normal Variants and Diseases of the Peroneal Tendons and Superior Peroneal Retinaculum: MR Imaging Features RadioGraphics, May 1, 2005; 25(3): 587 - 602. [Abstract] [Full Text] [PDF]

				J. Neustadter, S. M. Raikin, and L. N. Nazarian Dynamic Sonographic Evaluation of Peroneal Tendon Subluxation Am. J. Roentgenol., October 1, 2004; 183(4): 985 - 988. [Abstract] [Full Text] [PDF]

				Z. S. Rosenberg, J. Bencardino, D. Astion, M. E. Schweitzer, A. Rokito, and S. Sheskier MRI Features of Chronic Injuries of the Superior Peroneal Retinaculum Am. J. Roentgenol., December 1, 2003; 181(6): 1551 - 1557. [Abstract] [Full Text] [PDF]

				A. Saxena and S. K. Wolf Peroneal Tendon Abnormalities: A Review of 40 Surgical Cases J Am Podiatr Med Assoc, July 1, 2003; 93(4): 272 - 282. [Abstract] [Full Text] [PDF]

				O Minoyama, E Uchiyama, H Iwaso, K Hiranuma, and Y Takeda Two cases of peroneus brevis tendon tear Br. J. Sports Med., February 1, 2002; 36(1): 65 - 66. [Abstract] [Full Text] [PDF]

				M. P. Recht and B. G. Donley Magnetic Resonance Imaging of the Foot and Ankle J. Am. Acad. Ortho. Surg., May 1, 2001; 9(3): 187 - 199. [Abstract] [Full Text] [PDF]

				N. B. Chepuri, J. A. Jacobson, D. P. Fessell, and C. W. Hayes Sonographic Appearance of the Peroneus Quartus Muscle: Correlation with MR Imaging Appearance in Seven Patients Radiology, February 1, 2001; 218(2): 415 - 419. [Abstract] [Full Text]

				Z. S. Rosenberg, J. Beltran, and J. T. Bencardino MR Imaging of the Ankle and Foot RadioGraphics, October 1, 2000; 20(90001): 153S - 179. [Abstract] [Full Text]

				J. Rademaker, Z. S. Rosenberg, E. M. Delfaut, Y. Y. Cheung, and M. E. Schweitzer Tear of the Peroneus Longus Tendon: MR Imaging Features in Nine Patients Radiology, March 1, 2000; 214(3): 700 - 704. [Abstract] [Full Text]