Introduction The peroneal longus and brevis are both found in the lateral compartment of the lower extremity.
The peroneal longus and brevis are both found in the lateral compartment of the lower extremity. The peroneal brevis muscle originates from the distal fibula and will insert upon the base of the fifth metatarsal. The peroneal longus muscle originates more proximally on the fibula and will insert on both the base of the first metatarsal and the medial cuneiform.
Both tendons aid in plantarflexion and eversion of the foot. The two tendons are found together at the level of the retromalleolar sulcus on the distal fibula under the superior peroneal retinaculum (1,2). Image of the tendons at the level of the retromalleolar groove At the level of the sulcus, the peroneal brevis tendon is adjacent to the fibula and the peroneal longus sits superior.
Once the tendons reach the distal fibula, they are enclosed in the same tendon sheath until the peroneal tubercle, where the tendons go separate ways. Image showing the Superior Peroneal Retinaculum Also present in seven percent of the population is the peroneus quartus. This muscle will originate from the peroneal brevis muscle belly and insert on the peroneal tubercle.
The presence of a peroneus quartus is attributed as a risk factor to developing stenosing tenosynovitis. Patients with injury to their peroneal tendons will typically complain of posterolateral ankle pain. This pain can be secondary to tendinosis, tenosynovitis, tears, and dislocation of the tendons.
MRI Findings Tears of the peroneal tendons can be traumatic or due to repetitive trauma. Tears of the peroneal brevis are more commonly seen than tears of the peroneal longus. One of the more common pathologies seen on an MRI is a peroneal brevis split tear.
If you are experiencing symptoms that may be related to mri findings of peroneal tendon pathology, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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