scholarly journals Peroneal Tendoscopy

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0021
Author(s):  
İsmail Ayder Gülten ◽  
Mustafa Ürgüden ◽  
Hakan Bilbaşar ◽  
Fikri Feyyaz Akyıldız
Keyword(s):  
Tendon Rupture ◽  
Excision Repair ◽  
Osteochondral Lesions ◽  
Peroneal Tendon ◽  
Mri Findings ◽  
Ankle Joints ◽  
Mri Scans ◽  
Physical Examinations ◽  
Peroneus Brevis ◽  
Tendon Pathology

Objectives: Peroneal tendon pathology should be within the differential diagnoses of patients who are admitted to the hospital with posterolateral ankle pain. Peroneal tendoscopy is a minimally invasive choice for the diagnosis and the treatment of peroneal tendon pathologies. Aim of this study is to discuss the role of tendoscopy within the diagnosis and the treatment of peroneal tendon pathologies. Methods: From 2006 to 2012, 18 patients with retrofibular pain are included in this study. This study had been planned prospectively. For the patients who had been pre-diagnosed as ‘’ peroneal tendinopathy’’ with physical examination, X-ray and MRI findings, ‘’peroneal tendoscopy’’had been performed diagnostically. After diagnostic peroneal tendoscopy, patients were definitively treated either with tendoscopy or with open surgery. Results: We have included 18 patients with retrofibular pain, 13 were female and 5 were male. The mean age was 46.8 (29-71). Preoperatively taken MRI scans showed talar osteochondral lesions (TOL) in 8 patients, peroneal tenosynovitis in 8 patients (3 of them were with TOL), suspected peroneal tendon rupture in 3 patients (2 of them were with TOL, accessory peroneal tendon in 1 patient). MRI scans of 5 patients were normal regarding peroneal pathology, these patients were operated according to physical examinations and the findings. 13 of 18 patients had accompanying anterior and posterior ankle pathologies. The most common pathology which had been detected in 8 patients with retrofibular pain was talar ostechondral lesion (TOL). The other 5 patients had no concomitant pathology. During peroneal tendoscopy, accessory peroneal tendon in 6 patients and distal insertion of peroneus brevis tendon in 3 patients had been detected and excised minimally invasively. In 4 patients, peroneal tendon rupture had been detected and excision/repair/tenodesis had been performed, in 3 patients tenosynovectomy had been performed for peroneal tenosynovitis, duplication had been performed in 1 patient, tubulisation had been performed in 1 patient and vincula excision had been performed in 1 patient. Conclusion: Peroneal tendoscopy is a useful procedure to diagnose and to treat the pathology of peroneal tendons. According to our theory, patients could have a sensation of fullness within their ankle joints with the presence of accessory muscle and distal insertion of peroneus brevis tendon within the superior peroneal retinaculum and may put their ankle in slight inversion position. This positional change within the ankle may disturb the ankle biomechanics and may be one of the causes of osteochondral lesions of the talus.

scholarly journals Distribution of Osteochondral Lesions in Patients With Simple Elbow Dislocations Based on MRI Analysis

2020 ◽  
Vol 8 (8) ◽  
pp. 232596712094626
Author(s):  
Hyojune Kim ◽  
Erica Kholinne ◽  
Jae-Man Kwak ◽  
Dongjun Park ◽  
Myung-Jin Shin ◽  
...  
Keyword(s):  
Elbow Dislocation ◽  
Osteochondral Lesions ◽  
Lateral Side ◽  
Advanced Stage ◽  
Mri Findings ◽  
Level Of Evidence ◽  
Medial Side ◽  
Mri Scans ◽  
Bony Lesions

Background: The clinical relationship between osteochondral lesions and long-term outcomes and patterns in the elbow joint has not yet been established. A sole evaluation from plain standard radiography may underestimate the severity of bony lesions in patients with simple dislocations. It has been suggested that the mechanism of a posterior elbow dislocation could be inferred from the pattern of bony contusions and osteochondral lesions visible on magnetic resonance imaging (MRI) in patients with simple elbow dislocations. Purpose/Hypothesis: The purpose of this study was to describe the incidence and distribution of osteochondral lesions based on MRI findings in patients with simple elbow dislocations. We hypothesized that (1) osteochondral lesions are consistently found in patients with simple elbow dislocations and (2) the distribution and severity of osteochondral lesions may explain the mechanism of the simple elbow dislocation. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective review of 43 patients with simple elbow dislocations was performed in tertiary-level hospitals from January 2010 to August 2019. Two orthopaedic surgeons separately assessed the initial plain radiographs and MRI scans. Osteochondral lesions were evaluated and categorized based on whether they were located (1) on the lateral side (posterolateral capitellum and radial head; type 1) or (2) on the medial side (posterior trochlea and anteromedial facet of the coronoid; type 2). The severity of the osteochondral lesions was assessed according to the Anderson classification. Results: Of the 43 patients, 21 (48.8%) presented with osteochondral lesions on MRI. The type 1 pattern of osteochondral lesions was the most frequently observed on MRI in patients with simple elbow dislocations (69.8% of cases), and these were confirmed by simple radiography. Posterolateral capitellum osteochondral lesions were found in 13 patients. Among them, 10 (76.9%) were advanced-stage lesions (stages III and IV according to the Anderson classification). Conclusion: Osteochondral lesions were found on MRI after simple elbow dislocations at a rate of 48.8%. Osteochondral lesions in the posterolateral capitellum were associated with an advanced stage. Clinically, these findings may help surgeons in the diagnosis of osteochondral lesions and in determining how to manage patients with the progression of arthritic changes.

T2* Mapping of Peroneal Tendons Using Clinically Relevant Subregions in an Asymptomatic Population

2017 ◽  
Vol 38 (6) ◽  
pp. 677-683 ◽  
Author(s):  
Katharine J. Wilson ◽  
Rachel K. Surowiec ◽  
Nicholas S. Johnson ◽  
Carly A. Lockard ◽  
Thomas O. Clanton ◽  
...  
Keyword(s):  
T2 Mapping ◽  
Lateral Malleolus ◽  
Peroneal Tendon ◽  
Peroneal Tendons ◽  
Peroneus Longus ◽  
Mapping Sequence ◽  
Asymptomatic Volunteers ◽  
Peroneus Brevis ◽  
Magnetic Resonance Imaging Mri ◽  
Tendon Pathology

Background: Peroneal tendon evaluation is particularly demanding using current magnetic resonance imaging (MRI) techniques because of their curving path around the lateral malleolus. Quantifiable, objective data on the health of the peroneal tendons could be useful for improving diagnosis of tendon pathology and tracking post-treatment responses. The purpose of this study was to establish a method and normative T2-star (T2*) values for the peroneal tendons in a screened asymptomatic cohort using clinically reproducible subregions, providing a baseline for comparison with peroneal tendon pathology. Methods: Unilateral ankle scans were acquired for 26 asymptomatic volunteers with a 3-Tesla MRI system using a T2* mapping sequence in the axial and sagittal planes. The peroneus brevis and peroneus longus tendons were manually segmented and subregions were isolated in the proximity of the lateral malleolus. Summary statistics for T2* values were calculated. Results: The peroneus brevis tendon exhibited a mean T2* value of 12 ms and the peroneus longus tendon was 11 ms. Subregions distal to the lateral malleolus had significantly higher T2* values ( P < .05) than the subregions proximal in both tendons, in both the axial and sagittal planes. Conclusion: Peroneal tendon regions distal to the inferior tip of the lateral malleolus had significantly higher T2* values than those regions proximal, which could be related to anatomical differences along the tendon. Clinical Relevance: This study provides a quantitative method and normative baseline T2* mapping values for comparison with symptomatic clinically compromised peroneal tendon patients.

scholarly journals Pes Cavus and Hindfoot Varus Alignment Are Associated with Increased Rates of Peroneal Tendon Pathology

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0001
Author(s):  
Michelle Coleman ◽  
Hibba Aziz ◽  
Lorenzo Deveza ◽  
Hallie Bradley ◽  
Rowland Pettit ◽  
...  
Keyword(s):  
Ankle Instability ◽  
Categorical Variables ◽  
Osteochondral Lesions ◽  
Peroneal Tendon ◽  
Varus Alignment ◽  
Retrospective Case ◽  
Pes Cavus ◽  
Hindfoot Alignment ◽  
Tendon Pathology ◽  
Foot Alignment

Category: Hindfoot, Midfoot/Forefoot Introduction/Purpose: Cavovarus foot alignment has been significantly associated with increased rates of chronic ankle instability and osteochondral lesions of the talus. Clinical wisdom suggests that cavovarus foot alignment causes varus stress to the ankle and also predisposes individuals to peroneal tendon pathology. However, no studies have specifically explored this relationship. The purpose of this research is to investigate the association between foot alignment and peroneal tendon pathology. Methods: A retrospective case-control study was conducted of all adult patients in whom a magnetic resonance image (MRI) of the ankle was obtained for any reason at a single institution from 2015-2017. Patients were excluded if they had a charcot foot deformity or if they had undergone prior peroneal tendon, ankle, or hindfoot surgery. Arch alignment was evaluated on lateral weightbearing radiographs of the foot by measuring the adjusted navicular height. Hindfoot alignment was assessed using the Saltzman apparent moment arm method. Peroneal tendon pathology including tears, tendinosis, and tenosynovitis was documented by a fellowship-trained musculoskeletal radiologist using the MRI scan. All numerical variables were converted to categorical variables (e.g. varus, valgus, and normal alignment). Chi-square testing was utilized to determine the association between variables. Results: 195 patients were included in the study (average age 47 years, 61% female). Patients with hindfoot varus had significantly higher rates of peroneus longus (PL) and peroneus brevis (PB) tendon pathology than patients with neutral or valgus alignment (Figure 1 A, B)(PL 39% vs. 31% vs. 20%, p=0.01; PB 44% vs 27% vs. 27%, p=0.04). Patients with pes cavus demonstrated extremely high rates of peroneal tendon pathology, which was significantly higher than patients with neutral or pes planus alignment (Figure 1 C, D)(PL 71% vs. 28% vs. 9%, p<0.0001; PB 75% vs 30% vs. 26%, p<0.0001). Amongst patients with peroneal tendon pathology, there was no difference in the rates of symptomatic vs. asymptomatic findings based on hindfoot or pes alignment. Conclusion: This is the first study to demonstrate a statistically significant association between cavus foot alignment, hindfoot varus alignment, and peroneal tendon pathology. Interestingly, this study demonstrates that patients with cavovarus alignment are not more likely to be symptomatic than patients with normal and planovalgus alignment. This study also reinforces the idea that peroneal pathology found on MRI may not necessarily need surgery, as it is frequently seen in patients without symptoms. This information may be useful in counseling patients considering operative treatment for peroneal tendon pathology and alignment abnormalities.

scholarly journals Chronic and Recurrent Rectus Femoris Central Tendon Ruptures in Athletes: Clinical Picture, MRI Findings, and Results of Surgical Treatment

2021 ◽  
Vol 9 (2) ◽  
pp. 232596712098448
Author(s):  
Lasse Lempainen ◽  
Jussi Kosola ◽  
Xavier Valle ◽  
Jordi Puigdellivol ◽  
Juha Ranne ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Clinical Picture ◽  
Tendon Rupture ◽  
Case Series ◽  
Rectus Femoris ◽  
Tendon Injuries ◽  
Return To Play ◽  
Return To Sports ◽  
Mri Findings ◽  
Mri Scans

Background: Severe rectus femoris central tendon rupture is an uncommon sports-related injury. Most rectus femoris central tendon injuries can be treated by nonoperative means, but some tend to reinjure, resulting in chronic symptoms. Physicians treating athletes with rectus femoris injuries should be aware of this clinical condition and know that surgical treatment could be beneficial to the athlete if the rectus femoris central tendon rupture becomes chronic. Purpose: To describe the clinical picture, magnetic resonance imaging (MRI) findings, and surgical treatment results of rectus femoris central tendon injuries. Study Design: Case series; Level of evidence, 4. Methods: This study included 12 patients who underwent successful repair of recurrent rectus femoris central tendon rupture. Presurgical MRI scans were obtained and compared with the surgical findings. The time of return to play was recorded, and the outcome of surgical treatment was evaluated with validated Subjective Patient Outcome for Return to Sports (SPORTS) criteria: good = full return to preinjury level of sports without any symptoms; moderate = return to preinjury level of sports with some residual symptoms (mild discomfort during sports); and poor = did not return to preinjury level of sports. Results: Overall, 10 patients had a good outcome (83%), and 2 had a moderate outcome (17%). All athletes included in the study were able to return to sport at their preinjury levels 2.5 to 4 months postoperatively. Presurgical MRI scans correlated well with the surgical findings. Conclusion: The surgical treatment of rectus femoris central tendon rupture seems to be a good option in chronic and recurrent cases. After surgery and successful rehabilitation, the athlete is expected to continue sports at the preinjury level.

Chronic Peroneal Tendon Subluxation Produced by an Anomalous Peroneus Brevis: Case Report and Literature Review

Foot & Ankle ◽  
1989 ◽  
Vol 10 (1) ◽  
pp. 45-47 ◽  
Author(s):  
Warren A. Hammerschlag ◽  
J. Leonard Goldner
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Congenital Anomalies ◽  
Present Report ◽  
Peroneal Tendon ◽  
Anatomical Studies ◽  
Peroneal Tendons ◽  
Symptomatic Case ◽  
Peroneus Brevis ◽  
Time Of Operation

Although congenital anomalies of the peroneal muscles have been well documented from anatomical studies, only a single clinically symptomatic case has been previously reported. In the present report, a previously unreported variation of the peroneus brevis, a bifid peroneus brevis, is described. This variation contributed to chronic subluxation of the peroneal tendons. Diagnosis was made at the time of operation, and resection of the duplicated tendon and reinforcement of the peroneal retinaculum relieved the symptoms of the patient.

Partial achilles tendon rupture presenting with giant hematoma; MRI findings of 4 year follow up

The Foot ◽  
2011 ◽  
Vol 21 (4) ◽  
pp. 204-206
Author(s):  
Aysegul Sarsilmaz ◽  
Makbule Varer ◽  
Gulten Coskun ◽  
Melda Apaydın ◽  
Orhan Oyar
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Mri Findings

Peroneal Tendon Pathology Associated with Calcaneus Fractures

2020 ◽  
pp. 373-379
Author(s):  
Rull James Toussaint ◽  
Nicholas P. Fethiere ◽  
Dominic Montas
Keyword(s):  
Peroneal Tendon ◽  
Tendon Pathology ◽  
Calcaneus Fractures

scholarly journals Comparison of symptomatic spondylolysis in young soccer and baseball players

2020 ◽  
Author(s):  
Takuji Yokoe ◽  
Takuya Tajima ◽  
Hiroshi Sugimura ◽  
Shinichirou Kubo ◽  
Shotarou Nozaki ◽  
...  
Keyword(s):  
Contralateral Side ◽  
Soccer Players ◽  
Clinical Factors ◽  
Young Athletes ◽  
Mri Findings ◽  
Sports Activity ◽  
Baseball Players ◽  
Lumbar Level ◽  
Mri Scans ◽  
Dominant Side

Abstract Background: Spondylolysis is a main cause of low back pain (LBP) in young athletes. There are few studies analyzing the difference of spondylolysis among young athletes with different sports activity. The purpose of this study was to compare the clinical factors and distribution of the lesions of spondylolysis on magnetic resonance imaging (MRI) scans in young soccer and baseball players with symptomatic spondylolysis.Methods: The medical records of 267 young athletes aged 7 to 18 years old who underwent MRI to evaluate the cause of LBP between 2017 to 2020 were retrospectively reviewed to identify patients with spondylolysis. Of the young athletes with symptomatic spondylolysis, clinical factors and MRI findings in soccer and baseball players were retrospectively evaluated. The clinical factors were age, sex, interval from onset of LBP to MRI, and side of the dominant leg in the sports field. MRI findings included number, lumbar level, and side of the lesions. Results: A total of 33 soccer players (mean age, 15.4 ± 1.4 years) and 49 baseball players (mean age, 15.4 ± 1.6 years) with symptomatic spondylolysis were enrolled. All patients were male. No significant differences were noted in age and the interval from onset of LBP to MRI between the groups. Soccer players had greater numbers of multiple (p < 0.001) and bilateral (p < 0.001) lesions than baseball players. The dominant side of the hand for pitching or batting was correlated with the contralateral-side lesions in baseball players (p = 0.001).Conclusions: The distribution of the lesions of spondylolysis differed in young soccer and baseball players. Pitching or batting with the dominant-side hand would be associated with contralateral-side lesions in baseball players. Sports-specific movements and the side of the dominant leg should be considered when treating young athletes with symptomatic spondylolysis.

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