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Smoker BA, Giakas AM, Mills FB, Williams KA, Bornemann PH, Benjamin Jackson J. Prevalence of Abnormal Ultrasonographic Findings in Asymptomatic Peroneal Tendons. FOOT & ANKLE ORTHOPAEDICS 2023; 8:24730114231164146. [PMID: 37009419 PMCID: PMC10052504 DOI: 10.1177/24730114231164146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
Background: The peroneus longus (PL) and peroneus brevis (PB) tendons comprise the lateral compartment of the leg and stabilize the foot during weightbearing. Peroneal tendinopathy can precipitate lateral ankle pain and induce functional disability. The progression of peroneal pathology to lateral ankle dysfunction is thought to stem from asymptomatic, subclinical peroneal tendinopathy. There may be clinical benefit to identifying asymptomatic patients with this condition before progression to disability. Various ultrasonographic characteristics have been observed in peroneal tendinopathy. The purpose of this study is to identify the frequency of subclinical tendinopathic characteristics in asymptomatic peroneal tendons. Methods: One hundred seventy participants underwent bilateral foot and ankle ultrasonographic examination. Images were assessed for abnormalities of the PL and PB tendons by a group of physicians who recorded frequencies of abnormalities. This team consisted of an orthopaedic surgeon specializing in foot and ankle surgery, a fifth-year orthopaedic surgery resident, and a family medicine physician with musculoskeletal sonographer certification. Results: A total of 340 PL and 340 PB tendons were assessed. Sixty-eight (20%) PL and 41 (12.1%) PB tendons had abnormal traits. Twenty-four PLs and 22 PBs had circumferential fluid, 16 PLs and 9 PBs had noncircumferential fluid, 27 PLs and 6 PBs had thickening, 36 PLs and 12 PBs had heterogenicity, 10 PLs and 2 PBs had hyperemia, and 1 PL had calcification. In Caucasian participants, male gender was associated with increased frequency of abnormal findings, but there were no other significant differences based on age, body mass index, or ethnicity. Conclusion: In our studied population of 170 patients who had no complaints of associated symptoms, we found that 20% of PLs and 12% of PBs displayed ultrasonographic abnormalities. When we included all unusual findings within and around the tendons, prevalence rates of ultrasonographic abnormalities were 34% for PLs and 22% for PBs. Level of Evidence: Level II, prospective cohort study.
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Affiliation(s)
- Brice A. Smoker
- Department of Orthopedic Surgery, Prisma Health-USC Medical Center, Columbia, SC, USA
- Brice A. Smoker, BS, BA, Department of Orthopedic Surgery, Prisma Health-USC Medical Center, 302 S Prospect St, Columbia, SC 29205, USA.
| | - Alec M. Giakas
- Department of Orthopedic Surgery, Prisma Health-USC Medical Center, Columbia, SC, USA
| | - F. Baker Mills
- Department of Orthopedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Kevin A. Williams
- Department of Orthopedic Surgery, Children’s of Alabama/UAB, Birmingham, AL, USA
| | - Paul H. Bornemann
- Department of Family Medicine, Prisma Health-USC Medical Center, Columbia, SC, USA
| | - J. Benjamin Jackson
- Department of Orthopedic Surgery, Prisma Health-USC Medical Center, Columbia, SC, USA
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Milani C, Vyas K, Malik G. Evidence-Based Diagnosis and Treatments of Posterior Tibialis Tendinopathy. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2022. [DOI: 10.1007/s40141-022-00366-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Koutsogiannis P, Frane N, Aliyev T, Regala P, Tarazi JM, Bitterman AD. Peroneus Longus and Peroneus Brevis: A Review on Pathology and Updated Treatments. JBJS Rev 2022; 10:01874474-202205000-00003. [PMID: 35749775 DOI: 10.2106/jbjs.rvw.21.00238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
» Peroneus longus (PL) and peroneus brevis (PB) pathologies involve a variety of etiologies and degrees of dysfunction, which complicates their diagnoses. » Patient presentation includes a spectrum of disease; however, despite advanced imaging, a misunderstanding of the pathology and diagnostic algorithms has contributed to continued misdiagnoses. » This article summarizes the anatomy and the pathophysiology of the PL and the PB; it also provides updated treatment options and their associated outcomes in order to illuminate an often-misunderstood topic.
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Affiliation(s)
- Petros Koutsogiannis
- Department of Orthopaedic Surgery, Northwell Health-Huntington Hospital, Huntington, New York.,Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
| | - Nicholas Frane
- The Center for Orthopedic Research and Education (CORE) Institute, Phoenix, Arizona
| | - Teymur Aliyev
- Department of Physical Medicine & Rehabilitation, SUNY Downstate Medical Center, Brooklyn, New York
| | - Peter Regala
- Department of Orthopaedic Surgery, Northwell Health-Huntington Hospital, Huntington, New York.,Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
| | - John M Tarazi
- Department of Orthopaedic Surgery, Northwell Health-Huntington Hospital, Huntington, New York.,Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
| | - Adam D Bitterman
- Department of Orthopaedic Surgery, Northwell Health-Huntington Hospital, Huntington, New York.,Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
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