We present the rare case of a 47-year-old male long-distance runner who was referred to our hospital with a longstanding pain in his left calf. Clinical history, as well as ultrasound and magnetic resonance imaging scans, showed an accessory peroneal muscle. This muscle was identified as a peroneus quartus muscle. On ultrasound, controlled intracompartmental pressure measurement, a chronic peroneal compartment syndrome, was diagnosed. We performed an endoscopic-assisted fasciotomy of the peroneal compartment. This resolved the patient's symptoms completely and allowed the runner to return to competition shortly after the surgery.
Level of Clinical Evidence
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to The Journal of Foot and Ankle Surgery
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Congenital variations of the peroneus quartus muscle: an anatomic study.Foot Ankle Int. 1990; 11: 81-89
- The accessory peroneal (fibular) muscles: peroneus quartus and peroneus digiti quinti. A systematic review and meta-analysis.Surg Radiol Anat. 2015; 37: 617-627
- The peroneus quartus muscle.J Bone Jt Surg. 2003; 85: 1134-1137
- Peroneus quartus muscle as a rare cause of the chronic lateral ankle pain.Foot Ankle Surg. 2002; 8: 227-230
- The peroneus quartus muscle in a locking phenomenon of the ankle: a case report.J Foot Ankle Surg. 2017; 56: 108-111
- Reconstruction of the peroneal retinaculum using the peroneus quartus. A case report.J Bone Joint Surg Am. 1987; 69: 296-297
- Peroneus quartus muscle and ankle pain.Foot Ankle Surg. 2002; 8: 223-225
- Sonographic appearance of the peroneus quartus muscle: correlation with MR imaging appearance in seven patients.Radiology. 2001; 218: 415-419
- Endoscopic-assisted release of lower leg chronic exertional compartment syndromes: results of a systematic literature review.Sports Med Arthrosc Rev. 2016; 24: 19-23
- Modified criteria for the objective diagnosis of chronic compartment syndrome of the leg.Am J Sports Med. 1990; 18: 35-40
- Systematic review and recommendations for intracompartmental pressure monitoring in diagnosing chronic exertional compartment syndrome of the leg.Clin J Sport Med. 2012; 22: 356-370
- Chronic exertional compartment syndrome: diagnosis and management.Bull Hosp Jt Dis. 2005; 62: 77-84
- Peroneus quartus and functional ankle instability.Ann Phys Rehabil Med. 2011; 54: 282-292
- Anatomic variants associated with peroneal tendon disorders: MR imaging findings in volunteers with asymptomatic ankles.Radiology. 2007; 242: 509-517
Published online: May 23, 2019
Financial Disclosure: None reported.
Conflict of Interest: None reported.
© 2018 by the American College of Foot and Ankle Surgeons. All rights reserved.