Age / Sex : 56 / F

Chief complaint: Lateral foot pain for 1 month

1) What is your impression?

Two weeks later, you can see the final diagnosis with a brief discussion of this case.

(Quiz는 quiz일 뿐이오니 답안은 한개만 보내주시기 바라오며, 복수의 답안을 보내주시는 분은 정답이 포함되어 있더라도 부득이 semi-correct answer로 처리토록 하겠습니다.)

Courtesy: 김성준(Sungjun Kim), 연세대 강남세브란스병원(Gangnam Severance Hospital)

Split tear of peroneus longus with prominent (enlarged) peroneal tubercle

Discussion

Findings: Prominent
peroneal tubercle. Tendinosis and split tear of peroneus longus at the
inframalleoar level.

Differential Diagnosis: none

Diagnosis:
Split tear of peroneus longus by prominent (enlarged) peroneal tubercle

Discussion:

•       Peroneal tubercle is normal osseous
process on the lateral wall of the calcaneus

•       It separates the peroneus brevis
from the peroneus longus.

•       Reported incidence ranges from 36% to
97%.

•       Enlarged peroneal tubercle has been
reported to be present in 20.5 through 24% individuals.

•       A criterion defining an abnormality
in size of the peroneal tubercle has not been reported.

•       Some of these enlargements might be
acquired by trauma, altered weight bearing, and/or inflammatory changes related
to peroneus longus tendon spasms however, most of these enlargements are
principally believed to be congenital.

References:

Wang XT,
Rosenberg ZS,
Mechlin MB,
Schweitzer ME.
Normal variants and diseases of the peroneal tendons and superior peroneal
retinaculum: MR imaging features. Radiographics.
2005 May-Jun;25(3):587-602.