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Fibular trochlea

The fibular trochlea (also called the peroneal tubercle) is a bony prominence on the lateral surface of the calcaneus. It acts as a pulley-like structure separating the tendons of the fibularis (peroneus) longus and brevis muscles, facilitating their smooth course around the lateral aspect of the hindfoot.

It is an important anatomical landmark in foot and ankle anatomy, tendon biomechanics, and imaging of the lateral hindfoot.

Synonyms

  • Peroneal tubercle

  • Trochlea peronealis

Location

  • Situated on the lateral surface of the calcaneus

  • Anterior to the peroneal tubercle groove

  • Inferior to the lateral malleolus

  • Between the fibularis longus and fibularis brevis tendons

  • Part of the lateral wall of the calcaneus

Anatomical components

  • Osseous tubercle of the calcaneus

  • Superior groove:

    • For fibularis brevis tendon

  • Inferior groove:

    • For fibularis longus tendon

  • Periosteal covering and fibrocartilaginous interfaces

Relations

Superiorly:

  • Fibularis brevis tendon

Inferiorly:

  • Fibularis longus tendon

Anteriorly:

  • Cuboid bone region

Posteriorly:

  • Calcaneal body

Laterally:

  • Skin and subcutaneous tissue

Medially:

  • Calcaneal trabecular bone

X-ray appearance

Plain radiographs (lateral and oblique foot views):

  • Fibular trochlea: Small bony projection on the lateral calcaneal surface

  • Contour: Smooth, well-corticated

  • Best visualized on: Oblique lateral foot views

CT appearance

Non-contrast CT:

  • Fibular trochlea: Well-defined osseous prominence on lateral calcaneus

  • Cortical margins: Smooth and sharply outlined

  • Trabecular pattern: Normal cancellous bone

  • Tendon grooves: Superior and inferior grooves may be appreciated

MRI appearance

T1-weighted images:

  • Cortical bone: Low signal

  • Calcaneal marrow: High signal

  • Trochlear contour: Clearly outlined against adjacent soft tissues

T2-weighted images:

  • Cortex: Low signal

  • Adjacent tendons: Low signal bands

  • Tendon sheaths and fat planes: High signal

STIR:

  • Fat suppression: Uniform marrow fat suppression

  • Trochlear margins: Well delineated

  • Tendon paths: Clearly visualized

Proton density fat-saturated (PD FS):

  • Tendons: Low signal

  • Surrounding soft tissues: High contrast

MRI image

Fibular trochlea mri anatomy labelled image-img-00000-00000

CT VRT 3D image

Fibular trochlea 3d image