Question:

The clinical importance of identifying a peroneocalcaneus internus muscles is (choose all that apply):
1. Peroneocalcaneus internus muscles should be resected given the high association with neurovascular compromise.
2. Peroneocalcaneus internus muscles are a common cause of posterior ankle impingement.
3. Failure to identify a peroneocalcaneus internus muscle may affect posteromedial surgical approach.
4. Rarely is symptomatic.
5. Because they are often bilateral, identification of a peroneocalcaneus internus muscle should prompt contralateral ankle imaging.





Answer:

The correct answers for the question "The clinical importance of identifying a peroneocalcaneus internus muscles is (choose all that apply):" are:

3. Failure to identify a peroneocalcaneus internus muscle may affect posteromedial surgical approach.

4. Rarely is symptomatic.



Explanation
A. [The peroneocalcaneus internus (PCI) muscle is a rare accessory muscle of the medial ankle and it is thought to represent an asymptomatic finding.]

B. [The peroneocalcaneus internus muscle is a rare accessory muscle of the medial ankle and it is thought to represent an asymptomatic finding. There has been only one case report of symptomatic bilateral peroneocalcaneus internus muscles that were surgically resected with subsequent resolution of symptoms.  In that case report, the pain was thought to be secondary to posterior impingement rather than tibial neurovascular compression as seen with a symptomatic accessory flexor digitorum longus.]

C. [If a peroneocalcaneus internus is present, it may be mistaken for the flexor hallicus longus. The tibial neurovascular bundle is situated in a more anteromedial location with respect to the peroneocalcaneus internus.  Therefore, instrumentation more anteriorly to this location could damage the tibial neurovascular bundle which normally would be superficial and posteromedial to the flexor hallicus longus at this level.]

D. [There has been only one case report of symptomatic bilateral peroneocalcaneus internus muscles that were surgically resected with subsequent resolution of symptoms.  In that case report, the pain was thought to be secondary to posterior impingement rather than tibial neurovascular compression as seen with a symptomatic accessory flexor digitorum longus.]

E. [The peroneocalcaneus internus muscle is a rare accessory muscle of the medial ankle and it is thought to represent an asymptomatic finding.]



From the manuscript:
An Accessory Peroneocalcaneus Internus Muscle with MRI and US Correlation
Radiology Case. 2012 Oct; 6(10):20-25


This article belongs to the MSK section.




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From the manuscript

An Accessory Peroneocalcaneus Internus Muscle with MRI and US Correlation

Free full text article: An Accessory Peroneocalcaneus Internus Muscle with MRI and US Correlation

Abstract
The peroneocalcaneus internus (PCI) is a rare accessory muscle of the medial ankle with typical MRI anatomic features allowing differentiation from the more common accessory flexor digitorum longus muscle. To our knowledge, there have been no previously published sonographic images of the peroneocalcaneus internus. A PCI is typically an incidental, asymptomatic finding, but knowledge of the entity may avoid confusion when initially encountered by diagnostic ultrasound. We review the anatomic imaging features which allow for a confident imaging diagnosis and the clinical relevance of this anomaly.






References



1. Macalister A. Additional observations on muscular anomalies in human anatomy. Trans R Irish 1872; 25:125-130
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2. Perkins JD. An anomalous muscle of the leg: Peronaeocalcaneus internus. The Anatomical Record 1914; 8:21-25
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


3. Mellado JM, Rosenberg ZS, Beltran J, Colon E. The peroneocalcaneus internus muscle: MR imaging features. AJR Am J Roentgenol 1997; 169:585-588
Get full text
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4. Sookur PA, Naraghi AM, Bleakney RR, Jalan R, Chan O, White LM. Accessory Muscles: Anatomy, Symptoms, and Radiologic Evaluation1. Radiographics 2008; 28:481-499
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


5. Seipel R, Linklater J, Pitsis G, Sullivan M. The peroneocalcaneus internus muscle: an unusual cause of posterior ankle impingement. Foot Ankle Int 2005; 26:890-893
Get full text
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6. Phisitkul P, Amendola A. False FHL: a normal variant posing risks in posterior hindfoot endoscopy. Arthroscopy 2010; 26:714-718
Get full text
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7. Cheung YY, Rosenberg ZS, Colon E, Jahss M. MR imaging of flexor digitorum accessorius longus. Skeletal Radiology 1999; 28:130-137
Get full text
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8. Sammarco GJ, Stephens MM. Tarsal tunnel syndrome caused by the flexor digitorum accessorius longus. A case report J Bone Joint Surg Am 1990; 72:453-454
Get full text
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9. Sammarco GJ, Conti SF. Tarsal tunnel syndrome caused by an anomalous muscle. J Bone Joint Surg Am 1994; 76:1308-1314
Get full text
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10. Duran-Stanton AM, Bui-Mansfield LT. Magnetic resonance diagnosis of tarsal tunnel syndrome due to flexor digitorum accessorius longus and peroneocalcaneus internus muscles. J Comput Assist Tomogr 2010; 34:270-272
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


11. Lambert HW, Atsas S, Fox JN. The fibulocalcaneus (peroneocalcaneus) internus muscle of MacAlister: Clinical and surgical implications. Clin Anat 2011; 24:1000-1004
Get full text
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