Painful Os Peroneum Syndrome: Rare or Underdiagnosed Condition?
DOI:
https://doi.org/10.25759/spmfr.279Keywords:
Foot, Foot Diseases, Pain, Sesamoid Bones, SyndromeAbstract
Os Peroneum is an accessory ossicle located within the substance of the peroneus longus tendon that can cause pain in the lateral aspect of the foot. The painful Os Peroneum syndrome arises from a wide variety of conditions, such as impingement, fractures or diastasis of the Os Peroneum and can lead to tenosynovitis or rupture of the peroneus longus tendon. The differential diagnosis of lateral foot pain should consider this syndrome. Although diagnosis is mainly based in clinical features, imaging plays a significant role both in confirming the diagnosis and in therapeutic orientation. According to the literature, treatment varies with clinical severity, but is mostly surgical due to the syndrome’s typical acute presentation – the Os Peroneum fracture. The authors report an atypical case of chronic Os Peroneum syndrome without fracture that was documented by several imaging methods and treated conservatively by means of a customized rehabilitation programme achieving complete symptomatic resolution.
Downloads
References
Sobel M, Pavlov H, Geppert MJ, Thompson FM, DiCarlo EF, Davis WH. Painful os peroneum syndrome: a spectrum of conditions responsible for plantar lateral foot pain. Foot Ankle Int. 1994; 15: 112-24.
Bessette BJ, Hodge JC. Diagnosis of the acute os peroneum fracture. Singapore Med J. 1998; 39: 326-7.
Oh SJ, Kim YH, Kim SK, Kim MW. Painful os peroneum syndrome presenting as lateral plantar foot pain. Ann Rehabil Med. 2012; 36: 162-6. doi: 10.5535/arm.2012.36.1.163.
Benjamin M, Qin S, Ralphs JR. Fibrocartilage associated with human tendons and their pulleys. J Anat. 1995; 187: 625-33.
Favinger JL, Richardson ML, Chew FS. Progressive retraction of a fractured os peroneum suggesting repetitive injury to the peroneus longus tendon. Radiol Case Rep. 2018; 13: 216-9. doi:
1016/j.radcr.2017.11.006.
Nwawka OK, Hayashi D, Diaz LE. Sesamoids and accessory ossicles of the foot: anatomical variability and related pathology. Insights Imaging 2013; 4: 581-93. doi: 10.1007/s13244-013-0277-1.
Smith JT, Hohnson AH, Heckman JD. Nonoperative treatment of an os peroneum fracture in a high-level athlete. Clin Orthop Relat Res. 2011; 469: 1498-501. doi: 10.1007/s11999-011-1812-3.
Bianchi S, Bortolotto C, Draghi F. Os peroneum imaging: normal appearance and pathological findings. Insights Imaging. 2017; 8: 59-68. doi: 10.1007/s13244-016-0540-3.
Keles-Celik N, Kose O, Sekerci R, Aytac G, Turan A, Guler F. Accessory ossicles of the foot and ankle: disorders and a review of the literature. Cureus. 2017;9:e1881. doi: 10.7759/cureus.1881.
Chagas-Neto F, Souza B, Nogueira-Barbosa MH. Painful Os Peroneum syndrome underdiagnosed condition in the lateral midfoot pain. Case Rep Radiol. 2016;2016:8739362. doi: 10.1155/2016/8739362.
Mittal OS, Joshi SS, Chhaparwal SD. Prevalence and mophometry of Os Peroneum amongst Central Indians. J Clin Diagn Res. 2014; 8: AC08 – AC10.
Guimerá V, Lafuente A, Zambrana L, Rodrigyez-Niedenfuhr M, Sañudo JR, Vasquez T. The peroneocuboid joint: morphogenesis and anatomical study. J Anat. 2015; 226; 104-12. doi: 10.1111/joa.12249.
Manners-Smith T. A study of the cuboid and os peroneum in the primate foot. J Anat Physiol. 1908; 79: 201-4.
Bashir WA, Lewis S, Cullen N, Connel DA. Os peroneum friction syndrome complicated by sesamoid fatigue fracture: a new radiological diagnosis? Case report and literature review. Skeletal Radiol. 2009; 38: 181-6. doi: 10.1007/s00256-008-0588-3.
Roster B, Michelier P, Giza E. Peroneal tendon disorders. Clin Sports Med. 2015; 34; 625- 41.
Requejo SM, Kulig K, Thordarson DB. Management of foot pain associated with accessory bones of the foot: two clinical case reports. J Orthop Sports Phys Ther. 2000;30:580-91 discussion 592-4.
Peacock KC, Resnick EJ, Thoeder JJ. Fracture of the os peroneum with rupture of the peroneus longus tendon. Clin Orthop Relat Res. 1986; 202: 223-6.
Rademaker MK, Fessel DP, Jacobson JA. Radiography and US of os peroneum and associated peroneal tendon injuries: initial experience. Radiology. 2005; 237:235-41.
Saxena A, Cassidy A. Peroneal tendon injuries: an evaluation of 49 tears in 41 patientes. J Foot Ankle Surg. 2003; 42: 215-20.
Downloads
Published
How to Cite
Issue
Section
License
Copyright statement
Authors must also submit a copyright statement (as seen below) on article submission.
To the Editor-in-chief of the SPMFR Journal:
The below signed author(s) hereby state that the article
________________________________________ (ref. MFR_________) is
an original unpublished work and all facts stated are a product of the author(s) investigation. This article does not violate any copyright laws or privacy statements. The author(s) also hereby confirm that there is no conflict of interest's issues in this article.
By submitting this article the author(s) agree that after publication all copyrights belong to the SPMFR Journal.
Signed by all authors
Date:
Names (capital letters):
Signatures:
The SPMFR Journal’s contents are follow a Creative Commons licence. After publication the authors can hand out the articles as long as the SPMFR Journal is credited.
