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Peroneal nerve: Normal anatomy and pathologic findings on routine MRI of the knee.

Van den Bergh FR, Vanhoenacker FM, De Smet E, Huysse W, Verstraete KL - Insights Imaging (2013)

Bottom Line: On a routine MR examination without dedicated MR-neurography sequences the peroneal nerve can readily be assessed.Axial T1-weighted sequences are especially helpful as they allow a good differentiation between the nerve and the surrounding fat.In the second part we discuss the different pathologic conditions: accidental and surgical trauma, and intraneural and extraneural compressive lesions. • Six anatomical features contribute to the vulnerability of the peroneal nerve around the knee. • MR signs of muscle denervation within the anterior compartment are important secondary signs for evaluation of the peroneal nerve. • The most common lesions of the peroneal nerve are traumatic or compressive. • Intraneural ganglia originate from the proximal tibiofibular joint. • Axial T1-weighted images are the best sequence to visualise the peroneal nerve on routine MRI.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, AZ Sint-Maarten Duffel-Mechelen, campus Duffel, Rooienberg 25, 2570, Duffel, Belgium.

ABSTRACT

Background: Peroneal nerve lesions are not common and are often exclusively assessed clinically and electromyographically.

Methods: On a routine MR examination without dedicated MR-neurography sequences the peroneal nerve can readily be assessed. Axial T1-weighted sequences are especially helpful as they allow a good differentiation between the nerve and the surrounding fat.

Results: The purpose of this article is to review the normal anatomy and pathologic conditions of the peroneal nerve around the knee.

Conclusion: In the first part the variable anatomy of the peroneal nerve around the knee will be emphasized, followed by a discussion of the clinical findings of peroneal neuropathy and general MR signs of denervation. Six anatomical features may predispose to peroneal neuropathy: paucity of epineural tissue, biceps femoris tunnel, bifurcation level, superficial course around the fibula, fibular tunnel and finally the additional nerve branches. In the second part we discuss the different pathologic conditions: accidental and surgical trauma, and intraneural and extraneural compressive lesions.

Teaching points: • Six anatomical features contribute to the vulnerability of the peroneal nerve around the knee. • MR signs of muscle denervation within the anterior compartment are important secondary signs for evaluation of the peroneal nerve. • The most common lesions of the peroneal nerve are traumatic or compressive. • Intraneural ganglia originate from the proximal tibiofibular joint. • Axial T1-weighted images are the best sequence to visualise the peroneal nerve on routine MRI.

No MeSH data available.


Related in: MedlinePlus

Schematic drawing showing the variations at the level of bifurcation (thick black arrow) of the common peroneal nerve. In about 81 % of the people the bifurcation of the common peroneal nerve occurs at or below the level of the fibular neck (a). In about 9 % the peroneal nerve bifurcates between the fibular neck and the knee joint (b). In about 10 % bifurcation occurs above the knee joint line (c)
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Fig3: Schematic drawing showing the variations at the level of bifurcation (thick black arrow) of the common peroneal nerve. In about 81 % of the people the bifurcation of the common peroneal nerve occurs at or below the level of the fibular neck (a). In about 9 % the peroneal nerve bifurcates between the fibular neck and the knee joint (b). In about 10 % bifurcation occurs above the knee joint line (c)

Mentions: A third feature is a more proximal bifurcation of the peroneal nerve (Fig. 3). This is found in 10 % of preserved specimens and makes the peroneal nerve more prone to injury with arthroscopic inside-out lateral meniscal repair [7, 8].Fig. 3


Peroneal nerve: Normal anatomy and pathologic findings on routine MRI of the knee.

Van den Bergh FR, Vanhoenacker FM, De Smet E, Huysse W, Verstraete KL - Insights Imaging (2013)

Schematic drawing showing the variations at the level of bifurcation (thick black arrow) of the common peroneal nerve. In about 81 % of the people the bifurcation of the common peroneal nerve occurs at or below the level of the fibular neck (a). In about 9 % the peroneal nerve bifurcates between the fibular neck and the knee joint (b). In about 10 % bifurcation occurs above the knee joint line (c)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3675257&req=5

Fig3: Schematic drawing showing the variations at the level of bifurcation (thick black arrow) of the common peroneal nerve. In about 81 % of the people the bifurcation of the common peroneal nerve occurs at or below the level of the fibular neck (a). In about 9 % the peroneal nerve bifurcates between the fibular neck and the knee joint (b). In about 10 % bifurcation occurs above the knee joint line (c)
Mentions: A third feature is a more proximal bifurcation of the peroneal nerve (Fig. 3). This is found in 10 % of preserved specimens and makes the peroneal nerve more prone to injury with arthroscopic inside-out lateral meniscal repair [7, 8].Fig. 3

Bottom Line: On a routine MR examination without dedicated MR-neurography sequences the peroneal nerve can readily be assessed.Axial T1-weighted sequences are especially helpful as they allow a good differentiation between the nerve and the surrounding fat.In the second part we discuss the different pathologic conditions: accidental and surgical trauma, and intraneural and extraneural compressive lesions. • Six anatomical features contribute to the vulnerability of the peroneal nerve around the knee. • MR signs of muscle denervation within the anterior compartment are important secondary signs for evaluation of the peroneal nerve. • The most common lesions of the peroneal nerve are traumatic or compressive. • Intraneural ganglia originate from the proximal tibiofibular joint. • Axial T1-weighted images are the best sequence to visualise the peroneal nerve on routine MRI.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, AZ Sint-Maarten Duffel-Mechelen, campus Duffel, Rooienberg 25, 2570, Duffel, Belgium.

ABSTRACT

Background: Peroneal nerve lesions are not common and are often exclusively assessed clinically and electromyographically.

Methods: On a routine MR examination without dedicated MR-neurography sequences the peroneal nerve can readily be assessed. Axial T1-weighted sequences are especially helpful as they allow a good differentiation between the nerve and the surrounding fat.

Results: The purpose of this article is to review the normal anatomy and pathologic conditions of the peroneal nerve around the knee.

Conclusion: In the first part the variable anatomy of the peroneal nerve around the knee will be emphasized, followed by a discussion of the clinical findings of peroneal neuropathy and general MR signs of denervation. Six anatomical features may predispose to peroneal neuropathy: paucity of epineural tissue, biceps femoris tunnel, bifurcation level, superficial course around the fibula, fibular tunnel and finally the additional nerve branches. In the second part we discuss the different pathologic conditions: accidental and surgical trauma, and intraneural and extraneural compressive lesions.

Teaching points: • Six anatomical features contribute to the vulnerability of the peroneal nerve around the knee. • MR signs of muscle denervation within the anterior compartment are important secondary signs for evaluation of the peroneal nerve. • The most common lesions of the peroneal nerve are traumatic or compressive. • Intraneural ganglia originate from the proximal tibiofibular joint. • Axial T1-weighted images are the best sequence to visualise the peroneal nerve on routine MRI.

No MeSH data available.


Related in: MedlinePlus