RSNA 2012 

Abstract Archives of the RSNA, 2012


SSE14-03

Subluxation of the Peroneus Longus Tendon in the Cuboid Groove: Is It Normal or Pathology?

Scientific Formal (Paper) Presentations

Presented on November 26, 2012
Presented as part of SSE14: Musculoskeletal (Foot and Ankle)

Participants

Joshua Michael Ng MD, Presenter: Nothing to Disclose
Zehava Sadka Rosenberg MD, Abstract Co-Author: Nothing to Disclose
Gina Alexandra Ciavarra MD, Abstract Co-Author: Nothing to Disclose
Zoraida Restrepo Velez MD, Abstract Co-Author: Nothing to Disclose
Emma Marie Gorynski, Abstract Co-Author: Nothing to Disclose
Jenny T. Bencardino MD, Abstract Co-Author: Nothing to Disclose
Roberto Prost MD, Abstract Co-Author: Nothing to Disclose

PURPOSE

In contradistinction to the major anatomic and orthopedic literature which states that the peroneus longus tendon (PL) travels within the cuboid groove, along the plantar midfoot, we noted frequent asymptomatic subluxation of the tendon on ankle MRI studies. Rather than curve around the cuboid tuberosity, the tendon rides over it and travels proximally subluxed to the groove. The purpose of this paper is to describe the course of PL, relative to the cuboid groove, utilizing dynamic ultrasound (US) and 3T MRIs.  

METHOD AND MATERIALS

Institutional review board approval and informed consent were obtained for this US prospective and MRI retrospective HIPAA-compliant study. 20 feet in 10 normal volunteers underwent dynamic US in dorsiflexion and plantarflexion. The position of the PL relative to the cuboid tuberosity and cuboid groove was also documented in 55 consecutive 3T ankle MRI studies, based on sagittal and axial planes, in patients without clinical history of lateral ankle pain. Thirty four studies were performed on Verio (ankle in chimney coil, in dorsiflexion) and 21 on TrioTim (ankle in knee coil, in variable degrees of plantarflexion). 

RESULTS

US showed gliding motion of the PL in all volunteers. In dorsiflexion the PL rode over the cuboid tuberosity and was proximally subluxed to the cuboid groove. As the foot was plantarflexed, the PL moved distally to curve around the cuboid tubercle and travel within the cuboid groove. MRI demonstrated 17 cases (31%) with PL in the cuboid groove, 19 cases (53%) with a subluxed PL riding the cuboid tuberosity and 9 cases (16%) with the PL partially riding the tuberosity. The PL was in the groove in 52% of cases performed on TrioTim (variable plantarflexion) and in 17% of cases performed on Verio (full dorsiflexion).  

CONCLUSION

There is variability, related to foot position, in the location of PL relative to the cuboid groove. The tendon typically travels proximal to the groove in dorsiflexion and within the groove in plantarflexion. 

CLINICAL RELEVANCE/APPLICATION

The motion of the PL tendon in and out of the cuboid groove, not previously reported in the literature, is a normal finding which should not be misinterpreted as pathologic subluxation of the tendon.

Cite This Abstract

Ng, J, Rosenberg, Z, Ciavarra, G, Restrepo Velez, Z, Gorynski, E, Bencardino, J, Prost, R, Subluxation of the Peroneus Longus Tendon in the Cuboid Groove: Is It Normal or Pathology?.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12031514.html