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Ultrasound Diagnosis of Peroneal Tendon TearsA Surgical Correlation
Thomas H. Grant, DO1; Armen S. Kelikian, MD2; Sean E. Jereb, MD3; Robert J. McCarthy, PharmD4
1 Feinberg School of Medicine, Northwestern University, 676 North Saint Claire Street, Suite 800, Chicago, IL 60611. E-mail address: t-grant@northwestern.edu
2 Feinberg School of Medicine, Northwestern Orthopaedic Institute, Northwestern University, 680 North Lake Shore Drive, Suite 1028, Chicago, IL 60611
3 Orthopedic Specialists, 1030 West Higgins Road, #200, Hoffman Estates, IL 60195
4 Feinberg School of Medicine, Northwestern University, 251 East Huron Street, Chicago, IL 60611
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The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.
Investigation performed at Northwestern Memorial Hospital, Chicago, Illinois

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2005 Aug 01;87(8):1788-1794. doi: 10.2106/JBJS.D.02450
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Background: Musculoskeletal ultrasound is an established diagnostic technique for the assessment of tendon injuries. The purpose of the present study was to determine whether ultrasound is effective for evaluating peroneal tendon injuries, with surgical findings used as the standard of reference.

Methods: Fifty-eight patients with a suspected peroneal tendon injury were prospectively evaluated with use of dynamic ultrasound. Twenty-five patients were found to have peroneal tendon tears and were managed operatively. Five patients with normal peroneal tendons on ultrasound examination also were managed operatively for other reasons and are included in the series as the peroneal tendons were inspected at the time of the procedure. Ultrasound and surgical criteria were used to grade the peroneal tendons on a scale from grade 0 (normal tendon) to grade III (tendon rupture).

Results: Of the sixty tendons that were evaluated operatively, twenty-five were found to be torn. The sensitivity, specificity, and accuracy of ultrasonography were 100%, 85%, and 90%, respectively.

Conclusions: The use of dynamic ultrasound is effective for determining the presence or absence of a peroneal tendon tear and should be considered a first-line diagnostic tool.

Level of Evidence: Diagnostic Level III. See Instructions to Authors for a complete description of levels of evidence.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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