Peroneus longus and brevis tendon tears: MR imaging evaluation

PURPOSE: To evaluate magnetic resonance (MR) findings of surgically proved peroneal tendon tears. MATERIALS AND METHODS: MR images, medical records, and surgical findings were retrospectively reviewed in the cases of 12 patients who underwent surgery because of suspected peroneal tendon tear (14 tendons). Sagittal and oblique axial T1-weighted spin-echo and T2-weighted fast spin-echo images were obtained in all patients. RESULTS: At surgery, isolated peroneus longus tendon tears were seen in four patients, isolated peroneus brevis tendon tears in five, and both peroneus brevis and peroneus longus tendon tears in two. When correlated with surgical findings, findings at MR imaging were correct in 12 tendons. Findings were false-positive in two patients and false-negative in one, who underwent surgery anyway because unrelated abnormal MR findings were present. The most common MR finding was increased intra-substance signal intensity on T1- and T2-weighted images (11 tendons), in linear or rounded areas on oblique axial images (n = 11) and in linear areas along the longitudinal axis of the tendons on sagittal images (n = 7). Tendon distortion was noted in severe cases (five tendons). The most frequent surgical finding was a longitudinal tendon tear (split) (10 tendons). CONCLUSION: MR imaging enabled detection of peroneus brevis and peroneus longus tendon tears.