Peroneal tenosynovitis commonly presents in athletes and is usually due to repetitive activities, but direct trauma such as ankle fracture, calcaneal fracture, and chronic lateral ankle instability can also be a source. Furthermore, there are anatomic considerations that may cause peroneal tendon inflammation, including crowding of the tendons in the fibro-osseous canal by a low-lying peroneus brevis muscle or the presence of a peroneus quartus muscle/tendon that can also cause overcrowding of the tendon sheath. Tendon irritation can occur at the retromalleolar sulcus, peroneal tubercle, and the os perineum, where the tendons sheaths can become stenosed. Patients may have malalignment at the knee and/or ankle contributing to overload of the peroneals. A cavovarus foot commonly causes more stress on the lateral aspect of the foot and may lead to tenosynovitis, recurrent ankle sprains, or longitudinal peroneal tears.
Patients with peroneal tenosynovitis usually complain of pain and swelling at the lateral aspect of the ankle over the peroneals. A palpable thickening over the tendons may be present. The sub-talar joint range of motion may be limited secondary to peroneal spasm. The physical examination may reveal pain with passive inversion or resisted eversion and dorsiflexion of the foot. There may be a decrease in peroneal strength as well. If there is doubt about the source of lateral ankle pain, an injection of local anesthesia into the peroneal sheath can be diagnostic for pathology. Anteroposterior and lateral weight-bearing radiographs should be obtained to rule out bony injury.
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Everything you wanted to know about. How To Cure Tennis Elbow. Are you an athlete who suffers from tennis elbow? Contrary to popular opinion, most people who suffer from tennis elbow do not even play tennis. They get this condition, which is a torn tendon in the elbow, from the strain of using the same motions with the arm, repeatedly. If you have tennis elbow, you understand how the pain can disrupt your day.