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Dynamic Sonographic Evaluation of Peroneal Tendon Subluxation

Jason Neustadter1, Steven M. Raikin2 and Levon N. Nazarian1

1 Division of Ultrasound, Thomas Jefferson University Hospital, 132 S 10th St., 7 Main, Philadelphia, PA 19107-5244.
2 Department of Orthopaedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA 19107–5244.



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  		Fig. 1A. —20-year-old man with typical subluxation of right peroneal tendon. Axial sonogram obtained with affected ankle in neutral position shows peroneus longus (L) and peroneus brevis (B) tendons in normal relationship posterior to distal fibula (F).

 


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  		Fig. 1B. —20-year-old man with typical subluxation of right peroneal tendon. Axial sonogram obtained with affected ankle dorsiflexed and everted shows that peroneus longus (L) and peroneus brevis (B) tendons have subluxated anteriorly and now lie superficial relative to distal fibula (F).

 


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  		Fig. 2A. —20-year-old woman with retrofibular intrasheath subluxation of left peroneal tendon. Axial sonogram obtained with affected ankle in neutral position shows peroneus longus (L) and peroneus brevis (B) tendons in normal relationship posterior to distal fibula (F). Note slight flattening of peroneus brevis tendon when at rest.

 


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  		Fig. 2B. —20-year-old woman with retrofibular intrasheath subluxation of left peroneal tendon. Axial sonogram obtained with affected ankle dorsiflexed and everted shows that peroneus longus (L) and peroneus brevis (B) tendons have reversed their normal anteroposterior relationship, although they are still located behind distal fibula (F).

 


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  		Fig. 3. —17-year-old girl with severe subluxation of left peroneal tendon. Axial sonogram obtained with affected ankle dorsiflexed and everted shows that peroneus brevis (B) tendon has torn longitudinally into two parts, with more anterior part (arrow) subluxated over fibula (F). L = peroneus longus tendon.

 

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