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Prevalence of painful peroneal tubercles in the pediatric population.

Publication ,  Journal Article
Dutton, P; Edmonds, EW; Lark, RK; Mubarak, SJ
Published in: J Foot Ankle Surg
2012

Pain isolated to the lateral aspect of the heel can be difficult to diagnose, particularly in the growing child. Peroneal tendinopathy or frank tears of the peroneal tendons secondary to an enlarged peroneal tubercle has been implicated as a potential source of pain in adults. Neither the prevalence of enlarged peroneal tubercles in the pediatric population nor the number of symptomatic tubercles in children has been elucidated. We conducted a review of children who presented to our institution with foot and/or ankle pain and who underwent 3-dimensional computed tomography. Initially, a radiographic review was undertaken of all computed tomography scans to determine the prevalence of peroneal tubercles in children. The peroneal tubercles were measured and then classified according to height. The children with tubercles 3 mm or greater in height (adult mean height) underwent a more detailed chart review to evaluate for the incidence of painful tubercles. During the study period, 2,689 children were seen for foot and ankle pain, and 367 underwent a computed tomography scan during their treatment course. Of these 367 patients, 57% had a measurable peroneal tubercle, and 162 (44%) met the criteria for chart review. Only 3 adolescents (1.9%) were found to have clinical symptoms and ultimately underwent surgical excision with successful relief of symptoms. Peroneal tubercle hypertrophy appears to exist in the pediatric population; however, in contrast to adults with associated peroneal tendinopathy and tears, the children in our series had isolated painful tubercles without significant tendinopathy. The clinical examination is important in the diagnosis, and treatment by excision appears to be successful. Although a relatively rare etiology of pain, it is important that treating physicians keep this pathologic process in the differential diagnosis, because conservative management might not reduce the pain in these children.

Duke Scholars

Published In

J Foot Ankle Surg

DOI

EISSN

1542-2224

Publication Date

2012

Volume

51

Issue

5

Start / End Page

599 / 603

Location

United States

Related Subject Headings

  • Young Adult
  • Tomography, X-Ray Computed
  • Tendinopathy
  • Retrospective Studies
  • Pain
  • Orthopedics
  • Male
  • Hypertrophy
  • Humans
  • Foot Diseases
 

Citation

APA
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ICMJE
MLA
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Dutton, P., Edmonds, E. W., Lark, R. K., & Mubarak, S. J. (2012). Prevalence of painful peroneal tubercles in the pediatric population. J Foot Ankle Surg, 51(5), 599–603. https://doi.org/10.1053/j.jfas.2012.05.011
Dutton, Pascual, Eric W. Edmonds, Robert K. Lark, and Scott J. Mubarak. “Prevalence of painful peroneal tubercles in the pediatric population.J Foot Ankle Surg 51, no. 5 (2012): 599–603. https://doi.org/10.1053/j.jfas.2012.05.011.
Dutton P, Edmonds EW, Lark RK, Mubarak SJ. Prevalence of painful peroneal tubercles in the pediatric population. J Foot Ankle Surg. 2012;51(5):599–603.
Dutton, Pascual, et al. “Prevalence of painful peroneal tubercles in the pediatric population.J Foot Ankle Surg, vol. 51, no. 5, 2012, pp. 599–603. Pubmed, doi:10.1053/j.jfas.2012.05.011.
Dutton P, Edmonds EW, Lark RK, Mubarak SJ. Prevalence of painful peroneal tubercles in the pediatric population. J Foot Ankle Surg. 2012;51(5):599–603.
Journal cover image

Published In

J Foot Ankle Surg

DOI

EISSN

1542-2224

Publication Date

2012

Volume

51

Issue

5

Start / End Page

599 / 603

Location

United States

Related Subject Headings

  • Young Adult
  • Tomography, X-Ray Computed
  • Tendinopathy
  • Retrospective Studies
  • Pain
  • Orthopedics
  • Male
  • Hypertrophy
  • Humans
  • Foot Diseases