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Peroneal Nerve Injury
Andrew Sonin, MD, FACR
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KEY FACTS

  • Imaging

    • Top Differential Diagnoses

      • Pathology

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Common peroneal nerve (CPN); superficial peroneal nerve (SPN); deep peroneal nerve (DPN); peroneus longus muscle (PL); peroneus brevis muscle (PB); anterior tibial muscle (AT = tibialis anterior); extensor digitorum longus muscle (EDL); extensor hallucis longus muscle (EHL)
            • Synonyms

              • Strawberry picker palsy, slimmer disease
            • Definitions

              • Injury to or entrapment of CPN in its course through knee region

            IMAGING

            • General Features

              • Imaging Recommendations

                • Radiographic Findings

                  • MR Findings

                    • Ultrasonographic Findings

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Natural History & Prognosis

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Consider

                                    • Image Interpretation Pearls

                                      • Reporting Tips

                                        Selected References

                                        1. Ahlawat S et al: Three-dimensional imaging of lower limb neuropathies. Semin Musculoskelet Radiol. 19(2):168-78, 2015
                                        2. Andreisek G et al: MR neurography: pitfalls in imaging and interpretation. Semin Musculoskelet Radiol. 19(2):94-102, 2015
                                        3. Coraci D et al: Fibular nerve damage in knee dislocation: Spectrum of ultrasound patterns. Muscle Nerve. 51(6):859-63, 2015
                                        4. Damarey B et al: Imaging of the nerves of the knee region. Eur J Radiol. 82(1):27-37, 2013
                                        5. Mook WR et al: Nerve injury complicating multiligament knee injury: current concepts and treatment algorithm. J Am Acad Orthop Surg. 21(6):343-54, 2013
                                        6. Bruzzone M et al: The risk of direct peroneal nerve injury using the Ranawat "inside-out" lateral release technique in valgus total knee arthroplasty. J Arthroplasty. 25(1):161-5, 2010
                                        7. Papoutsidakis A et al: Peroneal nerve damage by bicortical tibial screw in ACL reconstruction. Knee Surg Sports Traumatol Arthrosc. 18(6):794-6, 2010
                                        8. Anderson AW et al: Common peroneal nerve neuropraxia after arthroscopic inside-out lateral meniscus repair. J Knee Surg. 22(1):27-9, 2009
                                        9. Hall MP et al: Risk of iatrogenic injury to the peroneal nerve during posterolateral femoral tunnel placement in double-bundle anterior cruciate ligament reconstruction. Am J Sports Med. 37(1):109-13, 2009
                                        10. Kapur S et al: Acute knee dislocation: review of an elusive entity. Curr Probl Diagn Radiol. 38(6):237-50, 2009
                                        11. Sanger JR et al: Peroneal nerve compression by lateral gastrocnemius flap. J Plast Reconstr Aesthet Surg. 62(8):e280-2, 2009
                                        12. Baima J et al: Evaluation and treatment of peroneal neuropathy. Curr Rev Musculoskelet Med. 1(2):147-53, 2008
                                        13. Frank DA et al: Peroneal nerve palsy secondary to ganglion cyst of the proximal tibiofibular joint in a pediatric patient. Orthopedics. 31(1):86, 2008
                                        14. Johnson ME et al: Neurologic and vascular injuries associated with knee ligament injuries. Am J Sports Med. 36(12):2448-62, 2008
                                        15. Ersozlu S et al: Common peroneal nerve palsy from an untreated popliteal pseudoaneurysm after penetrating injury. J Vasc Surg. 45(2):408-10, 2007
                                        16. Phisitkul P et al: Complications of locking plate fixation in complex proximal tibia injuries. J Orthop Trauma. 21(2):83-91, 2007
                                        17. Horan J et al: Proximal tibiofibular dislocation. Emerg Med J. 23(5):e33, 2006
                                        18. Bottomley N et al: Displacement of the common peroneal nerve in posterolateral corner injuries of the knee. J Bone Joint Surg Br. 87(9):1225-6, 2005
                                        19. Dellon AL: Postarthroplasty "palsy" and systemic neuropathy: a peripheral-nerve management algorithm. Ann Plast Surg. 55(6):638-42, 2005
                                        20. Gruber H et al: Peroneal nerve palsy associated with knee luxation: evaluation by sonography--initial experiences. AJR Am J Roentgenol. 185(5):1119-25, 2005
                                        21. Iverson DJ: MRI detection of cysts of the knee causing common peroneal neuropathy. Neurology. 65(11):1829-31, 2005
                                        22. Niall DM et al: Palsy of the common peroneal nerve after traumatic dislocation of the knee. J Bone Joint Surg Br. 87(5):664-7, 2005
                                        23. Krivić A et al: Lesion of the common peroneal nerve during arthroscopy. Arthroscopy. 19(9):1015-8, 2003
                                        24. Trappeniers L et al: Peroneal nerve injury in three patients with knee trauma: MR imaging and correlation with anatomic findings in volunteers and anatomic specimens. Eur Radiol. 13(7):1722-7, 2003
                                        25. Johnson DS et al: Common peroneal nerve palsy following knee arthroscopy. Arthroscopy. 15(7):773-4, 1999
                                        26. Mihalko WM et al: Transient peroneal nerve palsies from injuries placed in traction splints. Am J Emerg Med. 17(2):160-2, 1999
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Imaging

                                          • Top Differential Diagnoses

                                            • Pathology

                                              • Clinical Issues

                                                • Diagnostic Checklist

                                                  TERMINOLOGY

                                                  • Abbreviations

                                                    • Common peroneal nerve (CPN); superficial peroneal nerve (SPN); deep peroneal nerve (DPN); peroneus longus muscle (PL); peroneus brevis muscle (PB); anterior tibial muscle (AT = tibialis anterior); extensor digitorum longus muscle (EDL); extensor hallucis longus muscle (EHL)
                                                  • Synonyms

                                                    • Strawberry picker palsy, slimmer disease
                                                  • Definitions

                                                    • Injury to or entrapment of CPN in its course through knee region

                                                  IMAGING

                                                  • General Features

                                                    • Imaging Recommendations

                                                      • Radiographic Findings

                                                        • MR Findings

                                                          • Ultrasonographic Findings

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                CLINICAL ISSUES

                                                                • Presentation

                                                                  • Demographics

                                                                    • Natural History & Prognosis

                                                                      • Treatment

                                                                        DIAGNOSTIC CHECKLIST

                                                                        • Consider

                                                                          • Image Interpretation Pearls

                                                                            • Reporting Tips

                                                                              Selected References

                                                                              1. Ahlawat S et al: Three-dimensional imaging of lower limb neuropathies. Semin Musculoskelet Radiol. 19(2):168-78, 2015
                                                                              2. Andreisek G et al: MR neurography: pitfalls in imaging and interpretation. Semin Musculoskelet Radiol. 19(2):94-102, 2015
                                                                              3. Coraci D et al: Fibular nerve damage in knee dislocation: Spectrum of ultrasound patterns. Muscle Nerve. 51(6):859-63, 2015
                                                                              4. Damarey B et al: Imaging of the nerves of the knee region. Eur J Radiol. 82(1):27-37, 2013
                                                                              5. Mook WR et al: Nerve injury complicating multiligament knee injury: current concepts and treatment algorithm. J Am Acad Orthop Surg. 21(6):343-54, 2013
                                                                              6. Bruzzone M et al: The risk of direct peroneal nerve injury using the Ranawat "inside-out" lateral release technique in valgus total knee arthroplasty. J Arthroplasty. 25(1):161-5, 2010
                                                                              7. Papoutsidakis A et al: Peroneal nerve damage by bicortical tibial screw in ACL reconstruction. Knee Surg Sports Traumatol Arthrosc. 18(6):794-6, 2010
                                                                              8. Anderson AW et al: Common peroneal nerve neuropraxia after arthroscopic inside-out lateral meniscus repair. J Knee Surg. 22(1):27-9, 2009
                                                                              9. Hall MP et al: Risk of iatrogenic injury to the peroneal nerve during posterolateral femoral tunnel placement in double-bundle anterior cruciate ligament reconstruction. Am J Sports Med. 37(1):109-13, 2009
                                                                              10. Kapur S et al: Acute knee dislocation: review of an elusive entity. Curr Probl Diagn Radiol. 38(6):237-50, 2009
                                                                              11. Sanger JR et al: Peroneal nerve compression by lateral gastrocnemius flap. J Plast Reconstr Aesthet Surg. 62(8):e280-2, 2009
                                                                              12. Baima J et al: Evaluation and treatment of peroneal neuropathy. Curr Rev Musculoskelet Med. 1(2):147-53, 2008
                                                                              13. Frank DA et al: Peroneal nerve palsy secondary to ganglion cyst of the proximal tibiofibular joint in a pediatric patient. Orthopedics. 31(1):86, 2008
                                                                              14. Johnson ME et al: Neurologic and vascular injuries associated with knee ligament injuries. Am J Sports Med. 36(12):2448-62, 2008
                                                                              15. Ersozlu S et al: Common peroneal nerve palsy from an untreated popliteal pseudoaneurysm after penetrating injury. J Vasc Surg. 45(2):408-10, 2007
                                                                              16. Phisitkul P et al: Complications of locking plate fixation in complex proximal tibia injuries. J Orthop Trauma. 21(2):83-91, 2007
                                                                              17. Horan J et al: Proximal tibiofibular dislocation. Emerg Med J. 23(5):e33, 2006
                                                                              18. Bottomley N et al: Displacement of the common peroneal nerve in posterolateral corner injuries of the knee. J Bone Joint Surg Br. 87(9):1225-6, 2005
                                                                              19. Dellon AL: Postarthroplasty "palsy" and systemic neuropathy: a peripheral-nerve management algorithm. Ann Plast Surg. 55(6):638-42, 2005
                                                                              20. Gruber H et al: Peroneal nerve palsy associated with knee luxation: evaluation by sonography--initial experiences. AJR Am J Roentgenol. 185(5):1119-25, 2005
                                                                              21. Iverson DJ: MRI detection of cysts of the knee causing common peroneal neuropathy. Neurology. 65(11):1829-31, 2005
                                                                              22. Niall DM et al: Palsy of the common peroneal nerve after traumatic dislocation of the knee. J Bone Joint Surg Br. 87(5):664-7, 2005
                                                                              23. Krivić A et al: Lesion of the common peroneal nerve during arthroscopy. Arthroscopy. 19(9):1015-8, 2003
                                                                              24. Trappeniers L et al: Peroneal nerve injury in three patients with knee trauma: MR imaging and correlation with anatomic findings in volunteers and anatomic specimens. Eur Radiol. 13(7):1722-7, 2003
                                                                              25. Johnson DS et al: Common peroneal nerve palsy following knee arthroscopy. Arthroscopy. 15(7):773-4, 1999
                                                                              26. Mihalko WM et al: Transient peroneal nerve palsies from injuries placed in traction splints. Am J Emerg Med. 17(2):160-2, 1999