scholarly journals Painful Os Peroneum Syndrome: Underdiagnosed Condition in the Lateral Midfoot Pain

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Francisco Abaete Chagas-Neto ◽  
Barbara Nogueira Caracas de Souza ◽  
Marcello Henrique Nogueira-Barbosa
Keyword(s):  
Clinical Presentation ◽  
Wide Spectrum ◽  
Typical Case ◽  
Resonance Imaging ◽  
Lateral Aspect ◽  
Peroneus Longus Tendon ◽  
Longus Tendon ◽  
Peroneus Longus ◽  
Os Peroneum ◽  
Accessory Ossicle

Os peroneum is an accessory ossicle located within the peroneus longus tendon. The painful os peroneum syndrome (POPS) results from a wide spectrum of conditions, including fractures, diastases, and other causes. POPS can result in tenosynovitis or discontinuity of the peroneus longus tendon with a clinical presentation of pain in the lateral aspect of the midfoot. Authors report a typical case of POPS, illustrating this entity through different imaging methods (radiographs, ultrasound, and magnetic resonance imaging). We emphasize the prevalence of this ossicle and discuss painful complications.

scholarly journals Lateral Heel Pain Caused by Impingement of Hypertrophic Peroneal Tubercle and Os Peroneum

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Ryosuke Takada ◽  
Song Ho Chang ◽  
Taro Kasai ◽  
Masashi Naito ◽  
Jun Hirose ◽  
...  
Keyword(s):  
Heel Pain ◽  
Foot Pain ◽  
Resonance Imaging ◽  
Lateral Aspect ◽  
Peroneus Longus Tendon ◽  
Longus Tendon ◽  
Peroneus Longus ◽  
Os Peroneum ◽  
Accessory Ossicle ◽  
Preoperative Magnetic Resonance

Hypertrophic peroneal tubercle (HPT) is an overgrowth of the peroneal tubercle located on the lateral aspect of the hindfoot, which could cause tenosynovitis of the peroneus longus tendon. Os peroneum (OP) is an accessory ossicle that exists in the peroneus longus tendon at the lateral aspect of the calcaneocuboid joint. Both HPT and OP can cause lateral foot pain and occasionally require surgical treatment. We encountered a case of lateral foot pain of HPT coexisting with OP. Careful preoperative magnetic resonance imaging, dynamic ultrasonographic image, and block injection suggested an impingement of HPT and OP as a cause of lateral foot pain. Surgical resection of HPT, while retaining OP, successfully achieved pain relief in the patient. To the best of our knowledge, this is the first report presenting a case of HPT coexisting with OP successfully treated without OP resection.

Painful Os Peroneum Syndrome: A Spectrum of Conditions Responsible for Plantar Lateral Foot Pain

1994 ◽  
Vol 15 (3) ◽  
pp. 112-124 ◽  
Author(s):  
Mark Sobel ◽  
Helene Pavlov ◽  
Mark J. Geppert ◽  
Francesca M. Thompson ◽  
Edward F. DiCarlo ◽  
...  
Keyword(s):  
Callus Formation ◽  
Stress Test ◽  
Surgical Approaches ◽  
Foot Pain ◽  
Cast Immobilization ◽  
Radiographic Findings ◽  
Peroneus Longus Tendon ◽  
Longus Tendon ◽  
Peroneus Longus ◽  
Os Peroneum

Plantar lateral foot pain may be caused by various entities and the painful os peroneum syndrome (a term coined by the authors) should be included in the differential diagnosis. Painful os peroneum syndrome results from a spectrum of conditions that includes one or more of the following: (1) an acute os peroneum fracture or a diastasis of a multipartite os peroneum, either of which may result in a discontinuity of the peroneus longus tendon; (2) chronic (healing or healed) os peroneum fracture or diastasis of a multipartite os peroneum with callus formation, either of which results in a stenosing peroneus longus tenosynovitis; (3) attrition or partial rupture of the peroneus longus tendon, proximal or distal to the os peroneum; (4) frank rupture of the peroneus longus tendon with discontinuity proximal or distal to the os peroneum; and/or (5) the presence of a gigantic peroneal tubercle on the lateral aspect of the calcaneus which entraps the peroneus longus tendon and/or the os peroneum during tendon excursion. Familiarity with the various clinical and radiographic findings and the spectrum of conditions represented by the painful os peroneum syndrome can prevent prolonged undiagnosed plantar lateral foot pain. Clinical diagnosis of the painful os peroneum syndrome can be facilitated by the single stance heel rise and varus inversion stress test as well as by resisted plantarflexion of the first ray, which can localize tenderness along the distal course of the peroneus longus tendon at the cuboid tunnel. Radiographic diagnosis should include an oblique radiograph of the foot for visualization of the os peroneum and, if indicated, other imaging studies. Recommended treatment ranges from conservative cast immobilization to surgical approaches including: (1) excision of the os peroneum and repair of the peroneus longus tendon, and (2) excision of the os peroneum and degenerated peroneus longus tendon with tenodesis of the remaining remnant of peroneus longus to the peroneus brevis tendon.

scholarly journals COMPARATIVE ANATOMICAL STUDY AND INCIDENCE OF OS PERONEUM IN PERONEUS LONGUS TENDON AND ITS CLINICAL SIGNIFICANCE. Estudio anatómico comparativo e incidencia del os peroneum en el tendón de peroneo largo y su significación clínica

2016 ◽  
Vol 6 (1) ◽  
pp. 15-19
Author(s):  
Poonam Verma ◽  
Anterpeet Arora
Keyword(s):  
Incidence Rate ◽  
Clinical Significance ◽  
Anatomical Study ◽  
Peroneus Longus Tendon ◽  
Longus Tendon ◽  
Peroneus Longus ◽  
Calcaneocuboid Joint ◽  
Cuboid Bone ◽  
Os Peroneum ◽  
High Incidence Rate

Introducción: El objetivo de nuestro estudio fue evaluar la tasa de incidencia del os peroneo (OP) en el tendón del peroneo lateral largo (PLT) y su importancia clínica. Métodos: La disección de 60 cadáveres embalsamados (56 hombres y 4 mujeres) del grupo de mediana edad se hizo para tener acceso a la  tasa de incidencia del os peroneo en PLT. Resultados: En nuestro estudio se observó que la  tasa de incidencia del os peroneo fue de  86,6% (52  extremidades). La ubicación del os peroneo es también un tema de controversia. La mayoría de los autores afirman que se relaciona con el hueso cuboides y de vez en cuando se ve inferior al calcáneo distal a la articulación calcáneo-cuboidea. Pero en el presente estudio el os- peroneo estuvo en relación al hueso cuboides en 40 extremidades (76.9%)  y distal a articulación calcaneocuboidea en el resto de las 12 extremidades (23.1%). Conclusión: Este estudio sugiere que existe una alta tasa de incidencia de un OP en cadaveres. Esto puede ser como consecuencia de la técnica utilizada para localizar el mismo. La importancia clínica ha sido mencionada en relación con la ubicación del os peroneo, que puede ser confundido con fracturas estiloides y de Jones. Introduction: The aim of our study was to assess the incidence rate of the os peroneum (OP) in the peroneus longus tendon (PLT) and its clinical significance. Methods: Dissection of 60 embalmed cadavers (56 male and 4 female) of middle age group was done to access the incidence rate of os peroneum in peroneus longus tendon. Results: In our study the incidence rate of os peroneum was 86.6% (52 limbs). The location of os peroneum is also a subject of dispute. Most authors stated that it is related to the cuboid bone and occasionally it is seen inferior to the calcaneum distal to the calcaneocuboid joint. But in the present study os peroneum was in relation to cuboid bone in 40 limbs (76.9%) and distal to calcaneocuboid joint in 12 limbs (23.1%). Conclusion: This study suggests that there is a high incidence rate of the os peroneum in the peroneus longus tendon in cadavers. This may be a consequence of the technique used to locate it. The os peroneum can be mistaken for a styloid or Jones fractures.

Fracture of the Os Peroneum with Rupture of the Peroneus Longus Tendon: A Case Report

2001 ◽  
Vol 14 (4) ◽  
pp. 685 ◽  
Author(s):  
Yong Hoon Kim ◽  
Keun Woo Kim ◽  
Hak Jin Min ◽  
Eui Seong Yoon ◽  
Hee Oh Kim ◽  
...  
Keyword(s):  
Case Report ◽  
Peroneus Longus Tendon ◽  
Longus Tendon ◽  
Peroneus Longus ◽  
Os Peroneum

Peroneus Longus Tendon Tears: Acute and Chronic

1995 ◽  
Vol 16 (5) ◽  
pp. 245-253 ◽  
Author(s):  
G. James Sammarco
Keyword(s):  
Tendon Graft ◽  
Acute Onset ◽  
Symptom Duration ◽  
X Rays ◽  
Peroneus Longus Tendon ◽  
Longus Tendon ◽  
Peroneus Longus ◽  
Plantaris Tendon ◽  
Os Peroneum ◽  
Better Than

Tear of the peroneus longus tendon can be difficult to diagnose and treat. Fourteen cases of clinically proven tears are reported. Patients ranged in age from 31 to 63 years. There were 10 men and four women. The onset of symptoms was acute in eight cases. Chronic onset with slowly increasing pain occurred in six cases. Despite acute onset of symptoms, only one patient was diagnosed within 2 weeks of his injury. The others had symptom duration ranging from 7 to 48 months. Twelve tears were located distally as the tendon turned into the cuboid groove. An os peroneum visible on x-ray was present in six cases, absent in seven cases, and cartilaginous in one case. The os peroneum was involved in the tear in three cases. Excision of part or all of the os peroneum was performed in four cases with a bridging tendon graft required in one case. A plantaris tendon graft was required in one case in which an os peroneum was absent. Patients with acute onset of symptoms tended to fare better than those with chronic onset of symptoms, regardless of the length of time from onset to time of surgery. Associated pathology in the peroneus brevis tendon was common, occurring in nine cases. These patients seemed to have a better surgical outcome than those with only a tear of the peroneus longus tendon. Associated findings affected diagnosis by masking symptoms but did not alter the outcome of treatment. The presence or absence of an os peroneum did not affect symptoms or treatment, but its presence on x-rays may aid in the diagnosis if migration of part or all of the sesamoid occurs.

scholarly journals Peroneus Longus Tendon Regeneration after Anterior Cruciate Ligament Reconstruction with Magnetic Resonance Imaging Evaluation

2020 ◽  
Vol 8 (A) ◽  
pp. 916-920
Author(s):  
Sholahuddin Rhatomy ◽  
Bambang Kisworo ◽  
Bunarwan Prihargono ◽  
Faiz Alam Rasyid ◽  
Nolli Kressoni
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Acl Reconstruction ◽  
Ankle Joint ◽  
Cruciate Ligament ◽  
Resonance Imaging ◽  
Peroneus Longus Tendon ◽  
Longus Tendon ◽  
Peroneus Longus ◽  
Significant Difference

BACKGROUND: Peroneus longus graft can be recommended as a superior graft over hamstring in anterior cruciate ligament (ACL) reconstruction. There are many studies concerning hamstring tendon regeneration, but there are few studies on the regeneration of the peroneus longus tendon after ACL reconstruction. AIM: This study aimed to investigate whether regeneration of the peroneus longus tendon occurs after ACL reconstruction with magnetic resonance imaging. METHODS: Twenty-five patients underwent ACL reconstruction with donors from the peroneus longus tendon by the same operator and were followed 12 months later with bilateral crural magnetic resonance imaging (MRI) for comparison of the donor and healthy peroneus longus tendon areas. Regeneration was assessed at 5 cm, 10 cm, and 15 cm from the ankle joint. RESULTS: The average age 30.4 (18-38) years old. There were 17 right and 8 left knees involved in this study. The interval between surgery and MRI was 1 year. The average regeneration presentation was located in the distal part (5 cm from the ankle joint) 66.78%, medial part (10 cm from the joint) 63.2%, and proximal part (15 cm from the ankle joint) 67.53%. There was no significant difference in the presentation of proximal, medial, and distal areas while there was a significant difference between age and regeneration of the proximal area, p <0.05 (p = 0.047). Tissue regeneration was tendinous and it appeared smaller in the place where the tendons grew. CONCLUSION: Regeneration of the peroneus longus tendon occurred after ACL reconstruction at a 1-year follow-up according to MRI.

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