Os peroneum

Last revised by Nico Behnke on 26 Jun 2024

An os peroneum is a small accessory bone of the foot located at the lateral aspect of the cuboid within the substance of the fibularis longus tendon as it arches around the cuboid.

It is a very common anatomical variant, seen in up to 26% of feet 1.

It should not be mistaken for:

It can produce pathology (os peroneum syndrome) including fracture, fibularis longus tenosynovitis, and fibularis longus tendon tear.

Cases and figures

  • Figure 1: illustration
  • Case 1
  • Case 2
  • Case 3
  • Case 4
  • Case 5: os peroneum fracture
  • Case 6: with peroneus longus rupture
  • Case 7
  • Case 8
  • Case 9
  • Case 10: in case of Freiberg disease
  • Case 11: in a case of avulsion fracture 5th metatarsal styloid
  • Case 12
  • Case 13
  • Case 14: CT

Imaging differential diagnosis

  • Avulsion fracture 5th metatarsal
  • Avulsion fracture of the 5th metatarsal styloid (Pseudo-Jones)
  • Base of 5th metatarsal stress fracture
  • Os vesalianum pedis
  • Fifth metatarsal apophysis
  • Iselin disease: traction apophysitis base of the 5th metatarsal
  • Fractures of the proximal 5th metatarsal
  • Apophysis of 5th metatarsal (illustration)
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