Draghi Ferdinando, Bortolotto Chandra, Draghi Anna Guja, Gitto Salvatore
Radiology Institute, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Università Degli Studi di Pavia, Pavia, Italy.
Postgraduate School in Radiodiagnostics, Università Degli Studi di Milano, Milan, Italy.
J Ultrasound Med. 2018 Dec;37(12):2753-2758. doi: 10.1002/jum.14633. Epub 2018 Apr 19.
Peroneal intrasheath instability is a painful snapping condition of the lateral ankle. It consists of a transient retromalleolar subluxation of the peroneal tendons without disruption of the superior peroneal retinaculum or evidence of a previous definite trauma. In type A intrasheath instability, the peroneus longus and brevis tendons are intact, and there is an intertendinous intrasheath switch. In type B intrasheath instability, the peroneus brevis tendon has a longitudinal split tear through which the peroneus longus subluxates. Both types can be missed on a physical examination because there is no displacement of the peroneal tendons over the lateral malleolus. Dynamic ultrasound is the imaging modality of choice for evaluating retromalleolar subluxation of the peroneal tendons. This review article aims to provide an overview of the anatomic basis for peroneal intrasheath instability and provide physicians with guidelines for its ultrasound assessment.
腓骨肌腱鞘内不稳定是一种外侧踝关节疼痛性弹响病症。它表现为腓骨肌腱短暂性的踝后外侧半脱位，而腓骨上支持带未断裂，也无既往明确创伤的证据。在A型鞘内不稳定中，腓骨长肌腱和短肌腱完整，存在肌腱间鞘内换位。在B型鞘内不稳定中，腓骨短肌腱有纵向撕裂，腓骨长肌腱通过此撕裂处半脱位。两种类型在体格检查时都可能被漏诊，因为腓骨肌腱在外踝上方无移位。动态超声是评估腓骨肌腱踝后外侧半脱位的首选成像方式。这篇综述文章旨在概述腓骨肌腱鞘内不稳定的解剖学基础，并为医生提供其超声评估指南。
