Peroneal Ridge Syndrome, An Uncommon Etiology of Lateral Ankle Pain and Tendon Impingement: A Case Report

Biomedical Sciences | Case report | https://doi.org/10.47262/SL/13.1.132025200

Abdul Aleem Khan¹, Mohammed Junaid Ali², Kaibin Zhang¹, Xiangyang Dai², Yiran Zhu², Jian Qin²*

¹Department of Orthopedics, Department of Sports Medicine, Nanjing First Hospital, Nanjing Medical University, ChangLe Road 68, 210000, Nanjing, China

²Department of Orthopedics, Sir Run Run Hospital, Nanjing Medical University, Longmian Road 109, 211100, Nanjing, China

Abstract

Peroneal ridge syndrome is a rare condition in which the peroneal tendons become irritated or trapped by a bony projection on the fibula known as the peroneal ridge. This can lead to chronic lateral ankle pain and tendon dysfunction and is often mistaken for other, more common lateral ankle issues. We report the case of a 51-year-old woman who experienced persistent pain and discomfort in her left ankle for six months, worsened by weight-bearing activities. On examination, there was tenderness over the lateral aspect of the ankle. MRI revealed a prominent peroneal ridge causing mechanical impingement and inflammation of the peroneal tendons. Initial management with non-steroidal anti-inflammatory drugs (NSAIDs), physiotherapy, and activity modification offered limited relief. Due to ongoing symptoms, surgical excision of the bony ridge and decompression of the tendons was recommended. This case highlights the importance of recognizing peroneal ridge syndrome as a potential cause of chronic lateral ankle pain. MRI plays a critical role in diagnosing and treatment planning. Early identification and appropriate intervention, including surgical options when conservative treatment fails, can significantly improve patient outcomes and restore ankle function.