A clinical and radiological study of peroneal tendon pathology

Foot Ankle Spec. 2013 Dec;6(6):417-21. doi: 10.1177/1938640013501544. Epub 2013 Aug 21.

Abstract

Background: The proportion of patients with clinical findings referable to peroneal pathology and magnetic resonance imaging (MRI)-diagnosed peroneal tendon pathology is unknown. Previous studies have correlated surgical findings with clinical data and preoperative MRI, but there are no published studies that reference clinical examination findings to imaging findings.

Purpose: To determine the relationship between peroneal tendon pathology as diagnosed by MRI and clinical findings of peroneal tendon pathology.

Methods: Fifty-six patients who had both MRI evidence of peroneal tendon pathology and an associated clinical examination of the ankle were evaluated over a 3-year period at a tertiary care institution. Clinical examination criteria included lateral ankle tenderness, dislocation/snapping, and lateral ankle pain. A board-certified, fellowship-trained musculoskeletal radiologist confirmed the presence of MRI findings consistent with peroneal tendon pathology.

Results: Of the 56 patients with positive findings on MRI, 27 patients had an associated positive clinical exam and 29 patients had a negative clinical exam. The positive predictive value of MRI for peroneal tendon tears with positive clinical findings was 48% (95% confidence interval = 35% to 61%).

Conclusion: Patients with MRI findings of peroneal tendon pathology should undergo careful clinical examination, as the positive predictive value of MRI for peroneal tendon pathology with actual clinical findings is low. This study demonstrates that peroneal tendon tears are often incidental findings on MRI.

Keywords: MRI; clinical examination; peroneal tendon tears.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Ankle Injuries / diagnosis*
  • Ankle Injuries / surgery
  • Cohort Studies
  • Confidence Intervals
  • Female
  • Humans
  • Injury Severity Score
  • Joint Instability / diagnosis
  • Joint Instability / etiology
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Physical Examination / methods*
  • Predictive Value of Tests
  • Reproducibility of Results
  • Retrospective Studies
  • Sensitivity and Specificity
  • Tendinopathy / pathology
  • Tendinopathy / physiopathology
  • Tendon Injuries / complications
  • Tendon Injuries / diagnosis*
  • Tendon Injuries / pathology
  • Tendons / pathology*
  • Tendons / physiopathology