PURPOSE: To evaluate magnetic resonance (MR) findings of surgically pr
oved peroneal tendon tears. MATERIALS AND METHODS: MR images, medical
records, and surgical findings were retrospectively reviewed in the ca
ses of 12 patients who underwent surgery because of suspected peroneal
tendon tear (14 tendons). Sagittal and oblique axial T1-weighted spin
-echo and T2-weighted fast spin-echo images were obtained in all patie
nts. RESULTS: At surgery, isolated peroneus longus tendon tears were s
een in four patients, isolated peroneus brevis tendon tears in five, a
nd both peroneus brevis and peroneus longus tendon tears in two. When
correlated with surgical findings, findings at MR imaging were correct
in 12 tendons. Findings were false-positive in two patients and false
-negative in one, who underwent surgery anyway because unrelated abnor
mal MR findings were present. The most common MR finding was increased
intra-substance signal intensity on T1- and T2-weighted images (11 te
ndons), in linear or rounded areas on oblique axial images (n = 11) an
d in linear areas along the longitudinal axis of the tendons on sagitt
al images (n = 7). Tendon distortion was noted in severe cases (five t
endons). The most frequent surgical finding was a longitudinal tendon
tear (split) (10 tendons). CONCLUSION: MR imaging enabled detection of
peroneus brevis and peroneus longus tendon tears.