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Anatomic Variants Associated with Peroneal Tendon Disorders: MR Imaging Findings in Volunteers with Asymptomatic Ankles¹

¹ From the Departments of Radiology (N.S., B.M., C.W.A.P., M.Z.) and Orthopedic Surgery (P.V.), Orthopedic University Hospital Balgrist, Forchstrasse 340, CH-8008 Zurich, Switzerland; and Institute of Biostatistics, University of Zurich, Zurich, Switzerland (B.S.). Received December 8, 2005; revision requested January 20, 2006; revision received February 8; accepted March 3; final version accepted June 5. Address correspondence to N.S. (e-mail: nadja.saupe{at}balgrist.ch).

Purpose: To evaluate prospectively, on magnetic resonance (MR) images in volunteers with asymptomatic ankles, various features of anatomic variants that are potentially associated with peroneal tendon disorders.

Materials and Methods: The study had institutional review board approval; informed consent was obtained from each volunteer. The prevalence of accessory peroneus quartus muscles, the location of the muscle-tendon junction of the peroneus brevis muscle, the prevalence and size of the peroneal tubercle and the retrotrochlear eminence, and the shape of the retromalleolar fibular groove were evaluated on MR images in 65 volunteers with asymptomatic ankles (35 women, 30 men; age range, 23–70 years; median age, 45 years). MR images were analyzed by two radiologists in consensus. The relationship between anatomic features and age and sex was analyzed by using Spearman rank correlation and the Wilcoxon rank sum test.

Results: A peroneus quartus muscle was identified in 11 (17%) ankles. Ninety percent of the musculotendinous junctions of the peroneus brevis muscle were located in a range between 27 mm proximal to and 13 mm distal to the fibular tip (median, 0 mm). A peroneal tubercle was identified in 36 (55%) ankles. Ninety percent of all peroneal tubercles were 4.6 mm or smaller (median height, 2.9 mm). A retrotrochlear eminence was seen in all ankles (median, 3.0 mm; 90% were 4.6 mm or smaller). The retromalleolar groove was concave in 18 (28%), flat in 28 (43%), convex in 12 (18%), and irregular in seven (11%) volunteers. A significant difference (P = .04) for the height of the retrotrochlear eminence was found between men (median, 3.4 mm) and women (median, 2.5 mm). All other P values were greater than .05.

Conclusion: Anatomic variants thought to predispose individuals to peroneal tendon disorders can be seen in volunteers with asymptomatic ankles.

© RSNA, 2007

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