Subtendinous marrow edema - peroneus longus

Case contributed by Henry Knipe
Diagnosis certain

Presentation

Posterior ankle pain.

Patient Data

Age: 50 years
Gender: Male

Subcortical marrow edema at the lateral plantar aspect of the calcaneus where peroneus longus tendon passes. The peroneus longus tendon in this region is thickened with mild tendon sheath hyperintensity.

Insertional tendinopathy of the Achilles with partial thickness tearing as well as likely dystrophic calcification. Small effusions of the retrocalcaneal and retro-Achilles bursae.

Case Discussion

Subtendinous marrow edema is associated with overlying tendinopathy of the adjacent tendons. The etiology of the bone marrow edema is unclear but may be related to tendon friction or hyperemia. 

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