Published online Jan 18, 2019. doi: 10.5312/wjo.v10.i1.45
Peer-review started: November 14, 2018
First decision: November 29, 2018
Revised: December 14, 2018
Accepted: December 31, 2018
Article in press: January 1, 2019
Published online: January 18, 2019
Peroneal tendinopathies are an under-diagnosed and potentially under-treated pathology. If left untreated it can be a cause of chronic lateral hindfoot pain. Its diagnosis is challenging owing to its low incidence and vague clinical presentation.
We share a case of a patient who experienced a chronic lateral ankle pain exacerbated after alighting from a bus. This patient came to our attention only after failing conservative management on two separate occasions. Plain radiographs and magnetic resonance imaging revealed rupture of the peroneus longus tendon (PLT). Findings were confirmed intra-operatively and tenodesis of the PLT to the peroneus brevis was performed. Patient was kept non-weight-bear with his foot everted and in plantarflexion before being converted to an off-loading boot at two weeks. Patient was started on a progressive rehabilitation programme at six weeks and was able to return to work shortly after with excellent outcomes.
We aim to share our experience in managing this patient and propose some pointers guided by available literature to avoid missing this commonly overlooked pathology.
Core tip: Peroneus tendon pathologies are a group of under-appreciated cause of lateral ankle discomfort. Diagnosis is difficult as presenting complains are vague and concomitant ligamentous injury might be present. It is prudent to screen for peroneal tendon pathologies in patients complaining of lateral hindfoot tenderness or swelling.