How are peroneal tendon syndromes diagnosed and managed?

Updated: Mar 07, 2018
  • Author: Steven J Karageanes, DO, FAOASM; Chief Editor: Craig C Young, MD  more...
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Answer

Magnetic resonance imaging (MRI) is the criterion standard for identifying peroneal tendon injuries, which are demonstrated by the high signal intensity within the affected tendon on T2-weighted axial views. [6, 14, 15, 16, 17]

In the acute phase, most ankle injuries are managed with rest, ice, compression, and elevation (RICE), with or without a short period of no weight bearing. Nonsteroidal anti-inflammatory drugs (NSAIDs) can also be prescribed to reduce inflammation and pain. Once the swelling and pain have decreased, a more extensive examination can be performed. If the symptoms are minimal and if no significant instability is present, a rehabilitation program can be started. This program should include an ankle strengthening, flexibility, and proprioception regimen.

Surgery is indicated in the acute phase for peroneus brevis tendon rupture, acute dislocation, and anomalous peroneal brevis muscle hypertrophy and for peroneus longus tears that are associated with diminished function. [18, 19, 20]

For excellent patient education resources, visit eMedicineHealth's First Aid and Injuries Center. Also, see eMedicineHealth's patient education article Ankle Sprain.


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