Definition
Peroneal tendon dislocation is a rather rare injury in which the tendons connecting the lateral muscles of the lower leg to their points of attachment on the foot slip out of their normal anatomical position. The peroneal tendons run along the side of the foot from the lower leg behind the outer ankle and are held in position by a small additional strap. If this ligament is damaged due to injury, the tendons slip forward. This leads to a dislocation of the peroneal tendon, which can also occur as a chronic habitual form.
Symptoms
A peroneal tendon dislocation causes a number of typical symptoms. Due to the incorrect position of the tendons in front of the outer ankle, a bulge and swelling can be seen there, which is also caused by a slight inflammatory reaction. At this point, the peroneal tendon luxation can be palpated from the outside.
You can feel a sinewy structure that lies under the skin and slides under the finger with slight foot movements. Possibly a snapping of the tendons above the bone can be felt. Other symptoms of peroneal tendon dislocation are pain and instability.
The pain occurs mainly when walking and is mainly located behind the outer ankle. Pressure pain is also observed. Often the pain is also felt in the further course of the tendon, which is an expression of an incipient tendon inflammation caused by the peroneal tendon luxation. Certain instabilities in the ankle joint also occur as symptoms, which are particularly noticeable on uneven ground. Depending on the extent and cause of the peroneal tendon dislocation, further symptoms such as bruising or overheating and redness of the affected foot may occur.
Diagnostics
Questioning of the symptoms and clinical examination are the first steps in the diagnosis of peroneal tendon dislocation. Palpation of the dislocated tendon and the instability to be investigated by tests provide initial indications of the injury. Furthermore, imaging techniques can be used in diagnostics to confirm the diagnosis and exclude the extent and involvement of other structures besides the peroneal tendon luxation.
An x-ray indicates bony involvement, and ultrasound can be used to visualize the tendons and examine them for tears, inflammation and dislocation. In some cases, the MRI is used. An MRI (magnetic resonance tomograph) is used in cases of peroneal tendon luxation in cases of doubt, if a reliable result could not be obtained with previous diagnostics, or if the structures must be depicted more precisely.
For an MRI examination, the patient lies down in a tube, as with a CT (computer tomograph), while sectional images of the lower shekel and foot are taken. In contrast to CT, MRI does not involve X-rays or other dangerous radiation, and soft tissue can be assessed very well. MRI is a highly specific and highly sensitive detection of peroneal tendon dislocation.
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