title: Accuracy of MR findings in characterizing peroneal tendons disorders in comparison with surgery.
abstract: BACKGROUND
  Previous studies have shown that magnetic resonance imaging (MRI) has a high sensitivity for peroneal tendon pathology but more studies with surgery as a reference standard are needed.
  
  
  OBJECTIVE
  To evaluate the accuracy of MRI compared to surgery for characterizing chronic peroneal tendon pathology.
  
  
  METHODS
  Ninety-seven patients (57 men, 40 women; mean age, 39 years; range, 15-64 years) with chronic lateral ankle instability underwent MRI followed by surgery, with a mean MR to surgery interval of 30 days. Sagittal, coronal, and axial T1-weighted spin-echo and fat-suppressed T2-weighted fast spin-echo images were obtained for all patients. Two blinded observers evaluated the MR images without clinical information, and the results were compared to surgical findings. The following peroneal injuries were observed: tendon split, interstitial tear, swelling of the tendon, fluid collection, superior peroneal retinaculum injury, and tendon dislocation.
  
  
  RESULTS
  Swelling of the peroneus longus tendon was the most common finding on MR imaging, followed by fluid collection and a split of the peroneus brevis tendon. Surgical findings showed that nine cases (9%) of interstitial tears were in the peroneus brevis and two cases (2%) were in the peroneus longus, with eight cases (8%) of splits in the peroneus brevis tendon. The sensitivity and specificity for detecting interstitial tears in the peroneus brevis were 44% and 99%, respectively. The sensitivity and specificity for detecting swelling in the peroneus brevis were 50% and 99%, respectively. The sensitivity and specificity for detecting interstitial tears for peroneus longus injuries were 50% and 96%, respectively. The sensitivity and specificity for detecting swelling in these injuries were and 100% and 96%, respectively.
  
  
  CONCLUSIONS
  MRI findings of chronic peroneal tendon pathology are diagnostically specific but not sensitive. MRI showed high sensitivity for diagnosing tendon swelling in the peroneus longus, but not in the peroneus brevis. MRI is sensitive but not specific for detecting negative findings.
authors: Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Korea.
authors: Hee-Jin
authors: HJ
authors: Park
authors: So-Yeon
authors: SY
authors: Lee
authors: Noh-Hyuck
authors: NH
authors: Park
authors: Myung-Ho
authors: MH
authors: Rho
authors: Eun-Chul
authors: EC
authors: Chung
authors: Hyon-Joo
authors: HJ
authors: Kwag
mesh_terms: D000293:Adolescent; D000328:Adult; D000843:Ankle Joint / Q000601:surgery*; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis* / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D052256:Tendinopathy / Q000175:diagnosis* / Q000601:surgery*