Traumatic peroneal split lesion with retinaculum avulsion: Diagnosis and post-operative multymodality imaging

Abstract

Tears of peroneus brevis tendon represent a cause of underdiagnosed lateral ankle pain and instability. The typical clinical presentation is retro-malleolar pain, in some cases associated with palpable swelling around the fibular malleolus, pain during activities and difficulty in walking. We present a case of peroneus brevis split lesion with superior peroneal retinaculum avulsion in a young athlete who referred to the emergency ward of our hospital for left ankle pain after an inversion injury. An early diagnosis allowed treating the injury and promptly resuming sport activity, after rehabilitation training. Surgical reconstruction key-points and post-surgical follow-up were also discussed. A late diagnosis would have caused a symptomatology worsening and an increased recovery time.

Keywords: Multimodality imaging; Tendon injuries; Orthopedic surgery; Sport medicine; Ankle instability

Core tip: The article is based on the findings observed in a patient who was followed in our institution for a split lesion of the peroneus brevis after an inversion ankle sprain. Split lesion of peroneus brevis is usually under diagnosed, therefore we want to highlight the importance of ancillary sign, as detachment of an osseous fragment seen on the X-ray, since an early diagnosis can allow the patient to reduce recovery time. In the manuscript, we also provide post-operative ultrasound imaging which can be helpful during follow-up for monitoring the patient and to help him to restart sport practices.