Overview
Peroneal tendinitis involves inflammation or irritation of the tendons on the outer side of the ankle, commonly affecting the peroneus longus and brevis tendons, leading to pain and functional limitations 1.Diagnosis
Clinical presentation includes tenderness over the peroneal tendons, pain with resisted plantarflexion and eversion, and swelling 1.
Imaging studies such as ultrasound or MRI may be used to confirm diagnosis and rule out other conditions 1.
Grading systems often assess severity based on symptoms, physical examination findings, and imaging results 1.Management
First-line treatments: Rest, ice, compression, elevation (RICE protocol), nonsteroidal anti-inflammatory drugs (NSAIDs) for pain and inflammation 1.
Physical therapy: Includes stretching and strengthening exercises for the ankle and foot 1.
Adjunctive treatments: Corticosteroid injections may be considered for refractory cases, though evidence varies 1.
Surgical intervention: Indicated for chronic subluxation or failure of conservative management; modified Ellis Jones procedure for chronic peroneal subluxation has shown utility in specific cases 1.Special Populations
Pregnancy: Limited evidence; conservative management is typically recommended due to physiological changes affecting ankle stability 1.
Pediatrics: Specific guidelines are scarce; conservative treatment approaches are generally advised 1.
Elderly: Emphasis on conservative care with careful progression of physical therapy to avoid exacerbations 1.
Comorbidities: Management should consider coexisting conditions affecting mobility and healing, potentially necessitating individualized treatment plans 1.Key Recommendations
Initiate treatment with conservative measures including RICE and NSAIDs for symptom relief and functional improvement (Evidence: Moderate 1).
Incorporate physical therapy focusing on strengthening and flexibility exercises for the ankle and foot (Evidence: Moderate 1).
Consider surgical intervention, such as the modified Ellis Jones procedure, for chronic subluxation unresponsive to conservative treatment (Evidence: Weak 1).References
1 Thomas JL, Sheridan L, Graviet S. A modification of the Ellis Jones procedure for chronic peroneal subluxation. The Journal of foot surgery 1992. link