Published online May 28, 2018. doi: 10.4329/wjr.v10.i5.46
Peer-review started: February 13, 2018
First decision: April 11, 2018
Revised: April 23, 2018
Accepted: May 23, 2018
Article in press: May 23, 2018
Published online: May 28, 2018
Processing time: 106 Days and 10.1 Hours
Left ankle pain after an inversion injury, muscle functional impairment.
Swollen left ankle.
Differential diagnosis includes fibular malleolus fracture.
Unremarkable laboratory examination.
A radiography of the ankle excluded bone fracture but revealed the detachment of an osseous fragment; ultrasound demonstrated a diffuse swelling at the posterolateral aspect of the fibular malleolus and a split lesion of the peroneus (PB); MRI scan confirmed the PB split lesion and detects the avulsion of the fibular insertion of the superior peroneal retinaculum (SPR) and a shallow retro-malleolar groove with associated anterior luxation of the peroneus brevis tendon.
RICE treatment consists of rest, ice, compression, and elevation, anti-inflammatory can also be prescribed to reduce inflammation. Surgical treatment involves a side-to-side suture, combined with the reconstruction of SPR and the excision of the degenerative tissue.
This case suggests that integrated imaging is helpful for injury diagnosis and surgical planning. Unclear images, such as small bone detachment at plain films can be precious hints for the detection of underlying tendon pathology.