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Topic

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Neck of fibula

The neck of the fibula is the slightly constricted region just below the fibular head in the proximal part of the bone. It serves as an important landmark in the lateral leg due to its muscular attachments and neurovascular relations. The common peroneal nerve winds around the fibular neck, making it highly vulnerable to injury in fractures or external compression. This site is clinically important for evaluating trauma, entrapment neuropathies, and tumor or infection spread.

Synonyms

  • Fibular neck

  • Collum fibulae

  • Proximal fibular neck

Muscular Attachments

  • Biceps femoris tendon inserts on the lateral side of the fibular head and neck

  • Fibularis (peroneus) longus muscle originates partly from the lateral aspect of the fibular neck

  • Soleus muscle attaches to the posterior surface of the fibular neck

Relations

  • Anteriorly: Tibialis anterior muscle, anterior tibial vessels

  • Posteriorly: Soleus and plantaris muscles

  • Medially: Proximal tibiofibular joint and lateral condyle of tibia

  • Laterally: Subcutaneous tissue and skin

  • Neurovascular relation: Common peroneal (fibular) nerve winds laterally and posteriorly around the fibular neck, dividing into superficial and deep branches

Function

  • Provides attachment site for key muscles of the leg

  • Acts as a lever and stabilizing point for the lateral compartment

  • Serves as a bony landmark for surgical approaches and nerve localization

Clinical Significance

  • Fractures: Common in trauma; associated with common peroneal nerve palsy

  • Nerve injury: Compression or trauma to common peroneal nerve → foot drop

  • Tumors/Infection: Can extend from marrow or adjacent soft tissues

  • Surgical relevance: Landmark for fasciotomy and nerve decompression procedures

MRI Appearance

T1-weighted images:

  • Bone marrow shows intermediate to bright signal depending on fatty content

  • Cortex appears as low signal intensity

T2-weighted images:

  • Bone marrow shows intermediate to bright signal

  • Cortex remains low signal intensity

Proton Density (PD):

  • Bone marrow shows intermediate to bright signal

  • Useful for detecting marrow pathology (e.g., edema, contusion)

STIR (Short Tau Inversion Recovery):

  • Bone marrow shows low signal intensity in normal state

  • Pathological conditions (edema, infection, tumor) appear as bright hyperintense signal

Proton Density Fat-Saturated (PD FS):

  • Normal marrow shows low signal intensity

  • Pathological changes stand out as bright hyperintensity against suppressed fat background

T1 Fat-Sat Post-Contrast:

  • Normal marrow shows mild uniform enhancement

  • Pathologic marrow (infection, tumor, inflammation) demonstrates diffuse, nodular, or rim enhancement

CT Appearance

Non-Contrast CT:

  • Bone cortex appears as dense, high-attenuation structure

  • Marrow cavity shows lower attenuation than cortex

  • Fibular neck fractures appear as cortical disruption or displacement

  • Can show sclerotic or lytic lesions in tumors and metabolic disease

Post-Contrast CT:

  • Cortical bone does not enhance

  • Marrow may show subtle enhancement if infiltrated by tumor or infection

  • Surrounding soft tissues (nerve, vessels, muscles) may enhance with pathology

MRI image

Neck of fibula coronal cross sectional anatomy 3T MRI AI enhanced radiology anatomy image-img-00000-00000

MRI image

Neck of fibula sag cross sectional anatomy 3T MRI AI enhanced radiology anatomy image-img-00000-00000

CT image

Neck of fibula ct axial

CT image

Neck of fibula ct coronal

CT image

Neck of fibula ct sagittal