PMC9563226_01
A and B.
jbsr-106-1-2884-g1.jpg
PMC9563226_01_jbsr-106-1-2884-g1.jpg
F1
Conventional radiography and computed tomography revealed a detached osseous fragment at the posterolateral cortex of the lateral malleolus associated with locoregional soft tissue swelling (Figure 1 A-B, AP radiograph and coronal bone window, arrow).
A, B and C.
jbsr-106-1-2884-g2.jpg
PMC9563226_01_jbsr-106-1-2884-g2.jpg
F2
Subsequent magnetic resonance imaging (MRI) confirmed the fragment located at the distal attachment of the superior peroneal retinaculum with retraction of the retinaculum (Figure 2A, red arrow and green circle, respectively). Fat suppressed (FS) T2-weighted images (WI) showed bone marrow edema in the distal posterolateral fibula (Figure 2B: red arrow). In addition, there was slightly increased fluid in the inframalleolar part of the sheath of the peroneus tendon (Figure 2C, red arrow).
A and B.
jbsr-106-1-2884-g3.jpg
PMC9563226_01_jbsr-106-1-2884-g3.jpg
F3
Ultrasound confirmed multiple small avulsion fragments along with perilesional edema at the peroneal retinaculum (Figure 3A-B, red circle; Video 3C). Palpation during dynamic ultrasound demonstrated a ventral subluxation of the peroneal longus tendon between the fragments and the fibula (Figure 3A-B, Video 3C; PL = peroneus longus, PB = peroneus brevis).