Morphometric analysis of the peroneal tubercle using a three-dimensional computed tomography model

Abstract Background The peroneal tubercle is a small bony ridge located on the lateral wall on the calcaneus immediately inferior to the lateral malleolus and separates the peroneus brevis and peroneus longus tendons. The size and configuration of the peroneal tubercle has been implicated in the pathogenesis of peroneal tendon tears and tenosynovitis and is the increasing object of clinical interest. However, the morphology of the tubercle is difficult to assess with precision. Methods We utilized a new method to evaluate the three-dimensional (3D) geometry of 46 calcanei from 34 consecutive patients; average patient age was 48.0 years who underwent lower extremity computed tomography (CT) for clinical treatment of non-peroneal tubercle-related conditions. The 3D geometries of calcanei were reconstructed by using the computer software to calculate the surface 3D models. To measure the size of the peroneal tubercle, we virtually excised it from the 3D calcaneus model and made a precise measurement of the height. Results Peroneal tubercles with measured heights of 1mm or more were detected in 65% of the feet, with an average tubercle height of 2.59mm. Peroneal tubercles were larger and more frequent in middle-aged or older than younger patients.