Imaging Features of Symptomatic Hypertrophic Tuberculum Peroneum

Ultrasound measurements of the normal peroneal tubercle: validation of the normal anatomical measurements and evaluation of the intra- and interobserver reliability

Purpose

The aim of this study was to investigate if ultrasound could be a reliable and accurate tool to measure the size of the peroneal tubercle.

Material and methods

This study measured the width, length, and height of the peroneal tubercle in 100 asymptomatic patients, comparing the measurements to prior radiographs of the foot (if available) and previously reported anatomical data. This study also assessed the intra- and interrater reliability of ultrasound as a measurement tool.

Results

Our findings show that ultrasound measurements of the peroneal tubercle were consistent with values reported in the literature and prior radiographs concerning width. Both intra- and inter-observer measurements were reliable.

Conclusions

This study highlights the potential of ultrasound imaging as a promising tool to measure the peroneal tubercle, and it could contribute to a better understanding of peroneal tendon disorders.

Peroneus brevis tear caused by an impingement between hypertrophied peroneal tubercle and lateral malleolus

We report a 15-year-old female patient who sustained peroneus brevis injury caused by an impingement between the hypertrophied peroneal tubercle and lateral malleolus. The patient had pain for 3 years in the lateral side of her left ankle with unsuccessful conservative treatment. The oblique sagittal images of 3-dimensional magnetic resonance imaging and ultrasonography were useful in depicting the peroneus brevis injury and identifying the location of impingement between the hypertrophied peroneal tubercle and the tip of the lateral malleolus. The flatfoot deformity of the patient further aggravated the impingement. The patient was treated surgically, with excision of the enlarged tubercle and tendon repair. The ankle pain resolved 12 months postoperatively. Although rare, clinicians should recognize this condition as the cause of lateral ankle pain.