Back to the list
Congress: ECR25
Poster Number: C-22474
Type: Poster: EPOS Radiologist (educational)
Authorblock: G. Serrano, J. Torres, O. Campos, J. Cristi, R. Marin, M. Arias; Santiago/CL
Disclosures:
Gonzalo Serrano: Nothing to disclose
Jorge Torres: Nothing to disclose
Oscar Campos: Nothing to disclose
Joaquin Cristi: Nothing to disclose
Rodrigo Marin: Nothing to disclose
Marcelo Arias: Nothing to disclose
Keywords: Anatomy, Musculoskeletal soft tissue, CT, MR, Ultrasound, Education, Athletic injuries, Education and training
Learning objectives To review the anatomical and pathophysiological foundations of peroneal tendon instability, highlighting the role of dynamic ultrasound (US) in diagnosing various forms of instability, both intra-sheath and extra-sheath. Key dynamic manoeuvres for the practical evaluation of these patients will be demonstrated through clear explanations, illustrations, and didactic visuals.
Read more Background Peroneal tendon instability can be divided into intra-sheath, where abnormal tendon movement occurs without injury to the superior peroneal retinaculum (SPR), and extra-sheath, where the retinaculum is compromised. Each category includes important subtypes that must be recognized for accurate diagnosis. Frequently underdiagnosed, it is a common cause of chronic lateral ankle pain and should be suspected in patients with a history of dorsiflexion or inversion injuries. Early recognition is critical to avoid mismanagement, as it is often mistaken for lateral...
Read more Findings and procedure details ANATOMYA detailed understanding of the anatomy and anatomical variations of the peroneal tendons is essential to appreciate their role in lateral ankle stability. The peroneal tendons, composed of the peroneus longus (PL) and peroneus brevis (PB), are dynamic stabilisers of the ankle and act as evertors of the foot. Both originate from the fibula and descend laterally toward the foot, where they traverse the retromalleolar groove of the lateral malleolus. At this level, they share a common synovial sheath and are stabilised by the superior peroneal...
Read more Conclusion Peroneal tendon instability is an often overlooked cause of lateral ankle pain that benefits greatly from early and accurate diagnosis. Dynamic ultrasound stands out as the modality of choice, offering real-time evaluation of instability patterns that static MRI may miss. Its use ensures tailored management strategies, ranging from conservative measures to surgical interventions when indicated.
Read more References Neustadter J, Raikin SM, Nazarian LN. Dynamic sonographic evaluation of peroneal tendon subluxation. AJR Am J Roentgenol. 2004;183(4):985-988. doi:10.2214/ajr.183.4.1830985. Pesquer L, Guillo S, Poussange N, et al. Dynamic ultrasound of peroneal tendon instability. Br J Radiol. 2016;89(1063):20150958. doi:10.1259/bjr.20150958. Philbin TM, Landis GS, Smith B. Peroneal tendon injuries. J Am Acad Orthop Surg. 2009;17(5):306-317. doi:10.5435/00124635-200905000-00005. Lugo-Pico JG, Kaiser JT, Sanchez RA, Aiyer AA. Peroneal tendinosis and subluxation. Clin Sports Med. 2020;39(4):845-858. doi:10.1016/j.csm.2020.07.005. Davda K, Malhotra K, O'Donnell P, Singh D, Cullen N. Peroneal tendon disorders....
Read more
GALLERY