Ann Rehabil Med.  2012 Feb;36(1):163-166. 10.5535/arm.2012.36.1.163.

Painful Os Peroneum Syndrome Presenting as Lateral Plantar Foot Pain

• Oh SJ
• Kim YH
• Kim SK
• Kim MW

• KMID: 2266797
• DOI: http://doi.org/10.5535/arm.2012.36.1.163

Abstract

Lateral plantar foot pain can be caused by various entities, and the painful os peroneum syndrome should be considered in the differential diagnosis. Recent developments in musculoskeletal ultrasonography are very useful for initial diagnosis. We discuss a 69-year-old female who experienced lateral plantar foot pain for over one month. Through physical examination, radiography, ultrasound and magnetic resonance imaging, she was diagnosed with the painful os peroneum syndrome with a chronic fatigue fracture of multipartite os peroneum and peroneus longus tenosynovitis, for which she underwent surgery. We herein report this rare condition and reviewed the relevant literature.

Keyword

Painful os peroneum syndrome; Lateral plantar foot pain

MeSH Terms

Aged
Diagnosis, Differential
Female
Foot
Fractures, Stress
Humans
Magnetic Resonance Imaging
Physical Examination
Tenosynovitis

Figure

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  Fig. 1 Oblique view of the foot shows multipartite os peroneum at the level of the calcaneocuboid articulation (arrow).

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  Fig. 2 Longitudinal ultrasonography view shows tenosynovitis (arrow) of the peroneus longus tendon (empty arrowhead) aligned to os peroneum (arrowhead)(A), and transverse ultrasonography view shows cortical disruption of the os peroneum (arrowheads) (B).

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  Fig. 3 Sagittal (A) and coronal (B) fat-suppressed contrast-enhanced T1-weighted image (TR/TE 780/12) demonstrates os peroneum (arrow) near the cuboid bone, which is in the inflamed peroneus longus tendon (arrowheads).

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  Fig. 4 Intraoperative photograph shows an os peroneum (arrow) in the peroneus longus tendon (A), peroneus longus tendon (empty arrow), and excision of multipartite os peroneum (arrow) (B), anastomosis of peroneus longus tendon (C), and the excised multipartite os peroneum (D).

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