Tendon luxation of the outer ankle knuckle (peroneus luxation)

(Peroneus luxation)

The tendons surrounding the ankle joint are connected to the bones in several places by connective tissue strings (retinaculum). Two peroneus muscles are positioned behind the outer ankle knuckle, which are used to stabilise and flex the ankle joint.


  1. M. peroneus brevis
  2. M. peroneus longus
  3. Tendo calcaneus (Achillis)
  4. Bursa subcutanea malleoli lateralis
  5. Retinaculum mm. peroneorum inferius
  6. Vagina synovialis mm. peroneorum communis
  7. Retinaculum mm. peroneorum superius


Cause: Discomfort can be produced if a rupture of the connective tissue (retinaculum musculorum peroneorum superius & inferius) behind the outer ankle knuckle (malleolus lateralis) occurs. A rupture of the connective tissue (retinaculum) is relatively often combined with outer ligament injuries in the ankle joint.

Symptoms: Pain at the outer ankle knuckle (malleolus lateralis), where certain movements of the ankle joint can give rise to a painful sense of “slipping”.

Acute treatment: Click here.

Examination: When the painful movement of the ankle joint is performed, normal examination can detect the tendon slip over the outer ankle knuckle. A normal medical examination is usually sufficient in order
to make the diagnosis, however, if there is any doubt concerning the
diagnosis it can be made with certainty by use of ultrasound scanning while the ankle joint is in motion (dynamic ultrasound scanning). Ultrasound scanning will reveal whether there is bleeding in the acute stage. Inflammation of the tendon sheath can develop at a later stage.

Treatment: Treatment is primarily concentrated on providing rest from the painful activities (running). If steady progress from rest and rehabilitation is not achieved, and ultrasound scanning reveals inflammation of the tendon sheath, the treatment can be supplemented by medicinal treatment in the form of rheumatic medicine (NSAID) Alternatively, draining and evaluating fluid can be performed, and injection of corticosteroid into the tendon sheath. Injection into the tendon sheath is best performed if ultrasound guided. Surgical intervention can be attempted in certain cases, if resting, rehabilitation and medicinal treatment do not provide the desired result (article).

Complications: If there is not a steady improvement in the condition consideration must be given as to whether the diagnosis is correct, or if complications have arisen:

Possibly supplement with further examinations (x-ray, ultrasound scanning).