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Skeletal Radiol. 2019 Feb 15. doi: 10.1007/s00256-019-3168-9. [Epub ahead of print]

The peroneus longus muscle and tendon: a review of its anatomy and pathology.

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Department of Diagnostic Imaging, National University Health System, 1E Kent Ridge Rd, Singapore, 119074, Singapore.
Yong Loo Lin School of Medicine, National University of Singapore, Block MD11, 10 Medical Drive, Singapore, 117597, Singapore.
Department of Radiology, University of California, San Diego Medical Center, 408 Dickinson Street, San Diego, 92103, CA, USA.


This article will review the anatomy and common pathologies affecting the peroneus longus muscle and tendon. The anatomy of the peroneus longus is complex and its long course can result in symptomatology referable to the lower leg, ankle, hindfoot, and plantar foot. Proximally, the peroneus longus muscle lies within the lateral compartment of the lower leg with its distal myotendinous junction arising just above the level of the ankle. The distal peroneus longus tendon has a long course and makes two sharp turns at the lateral ankle and hindfoot before inserting at the medial plantar foot. A spectrum of pathology can occur in these regions. At the lower leg, peroneus longus muscle injuries (e.g., denervation) along with retromalleolar tendon instability/subluxation will be discussed. More distally, along the lateral calcaneus and cuboid tunnel, peroneus longus tendinosis and tears, tenosynovitis, and painful os peroneum syndrome (POPS) will be covered. Pathology of the peroneus longus will be illustrated using clinical case examples along its entire length; these will help the radiologist understand and interpret common peroneus longus disorders.


Cuboid tunnel; Os peroneum; Painful os peroneum syndrome (POPS); Peroneocuboid joint; Peroneus longus; Peroneus longus muscle injury; Peroneus longus tendinosis and tears; Peroneus longus tendon subluxation/instability; Retromalleolar groove; Tenosynovitis


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