Giza Eric, Mak Walter, Wong Stephanie E, Roper Glade, Campanelli Valentina, Hunter John C
Department of Orthopaedics (EG, SEW), University of California Davis, Sacramento, California.
Foot Ankle Spec. 2013 Dec;6(6):417-21. doi: 10.1177/1938640013501544. Epub 2013 Aug 21.
The proportion of patients with clinical findings referable to peroneal pathology and magnetic resonance imaging (MRI)-diagnosed peroneal tendon pathology is unknown. Previous studies have correlated surgical findings with clinical data and preoperative MRI, but there are no published studies that reference clinical examination findings to imaging findings.
To determine the relationship between peroneal tendon pathology as diagnosed by MRI and clinical findings of peroneal tendon pathology.
Fifty-six patients who had both MRI evidence of peroneal tendon pathology and an associated clinical examination of the ankle were evaluated over a 3-year period at a tertiary care institution. Clinical examination criteria included lateral ankle tenderness, dislocation/snapping, and lateral ankle pain. A board-certified, fellowship-trained musculoskeletal radiologist confirmed the presence of MRI findings consistent with peroneal tendon pathology.
Of the 56 patients with positive findings on MRI, 27 patients had an associated positive clinical exam and 29 patients had a negative clinical exam. The positive predictive value of MRI for peroneal tendon tears with positive clinical findings was 48% (95% confidence interval = 35% to 61%).
Patients with MRI findings of peroneal tendon pathology should undergo careful clinical examination, as the positive predictive value of MRI for peroneal tendon pathology with actual clinical findings is low. This study demonstrates that peroneal tendon tears are often incidental findings on MRI.
临床检查发现提示腓骨病变的患者比例以及磁共振成像（MRI）诊断的腓骨肌腱病变比例尚不清楚。既往研究已将手术结果与临床数据及术前MRI进行了关联，但尚无已发表的研究将临床检查结果与影像学结果进行对照。
确定MRI诊断的腓骨肌腱病变与腓骨肌腱病变临床检查结果之间的关系。
在一家三级医疗机构的3年时间里，对56例既有腓骨肌腱病变的MRI证据又有关联的踝关节临床检查的患者进行了评估。临床检查标准包括外踝压痛、脱位/弹响以及外踝疼痛。一名获得委员会认证、接受过专科培训的肌肉骨骼放射科医生确认了与腓骨肌腱病变相符的MRI检查结果的存在。
在56例MRI检查结果呈阳性的患者中，27例临床检查结果呈阳性，29例临床检查结果呈阴性。MRI对临床检查结果呈阳性的腓骨肌腱撕裂的阳性预测值为48%（95%置信区间=35%至61%）。
MRI检查发现有腓骨肌腱病变的患者应接受仔细的临床检查，因为MRI对实际临床检查结果为阳性的腓骨肌腱病变的阳性预测值较低。本研究表明，腓骨肌腱撕裂在MRI上常为偶然发现。
