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Purpose <p>To determine the accuracy of ultrasonography for quantifying the locations of the peroneus brevis (PB) tendon and lateral band of the plantar fascia (LPF) insertions at the fifth metatarsal base, measured relative to the fourth/fifth intermetatarsal joint (4/5 IMJ), using cadaveric direct visualization as the reference standard.</p> Methods <p>Six fresh-frozen cadaveric feet underwent standardized ultrasonographic identification of the fifth metatarsal long axis, distal 4/5 IMJ, and distal ends of PB and LPF insertions. Distances from the 4/5 IMJ to each insertion were measured along the metatarsal axis. After dissection, identical measurements were repeated under direct visualization. Primary outcomes were sonography–direct visualization measurement errors; secondary outcomes were positional deviations of each landmark.</p> Results <p>PB was correctly identified in all specimens, whereas LPF was misidentified in one foot. The PB distance error was 0.3 ± 1.5&#xa0;mm (maximum 2.1&#xa0;mm). LPF error was 2.5 ± 3.4&#xa0;mm overall, improving to 1.2 ± 1.6&#xa0;mm after excluding the misidentified case. Distal 4/5 IMJ localization showed minimal deviation (− 0.1 ± 0.9&#xa0;mm).</p> Conclusion <p>Ultrasonography enables quantification of PB insertion location and reliable localization of the distal 4/5 IMJ, supporting in vivo assessment of tendon insertion at the fifth metatarsal. LPF assessment is feasible but less robust and more susceptible to misidentification indicating the need for refined scanning protocols, specific operator training. The results of this study provide a foundation for identification of individual anatomical variations in the tendon insertion.</p>

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Accuracy of ultrasonography for quantifying tendon insertion locations at the fifth metatarsal base in a preliminary cadaveric validation study

  • 期刊论文

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  • 发表日期：

    2026年8月4日

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  • Yuta Maeda,
  • Satoshi Yamaguchi,
  • Mutsuaki Edama,
  • Yoshitomo Saita,
  • Takane Suzuki,
  • Yuichi Yamada

摘要

Purpose

To determine the accuracy of ultrasonography for quantifying the locations of the peroneus brevis (PB) tendon and lateral band of the plantar fascia (LPF) insertions at the fifth metatarsal base, measured relative to the fourth/fifth intermetatarsal joint (4/5 IMJ), using cadaveric direct visualization as the reference standard.

Methods

Six fresh-frozen cadaveric feet underwent standardized ultrasonographic identification of the fifth metatarsal long axis, distal 4/5 IMJ, and distal ends of PB and LPF insertions. Distances from the 4/5 IMJ to each insertion were measured along the metatarsal axis. After dissection, identical measurements were repeated under direct visualization. Primary outcomes were sonography–direct visualization measurement errors; secondary outcomes were positional deviations of each landmark.

Results

PB was correctly identified in all specimens, whereas LPF was misidentified in one foot. The PB distance error was 0.3 ± 1.5 mm (maximum 2.1 mm). LPF error was 2.5 ± 3.4 mm overall, improving to 1.2 ± 1.6 mm after excluding the misidentified case. Distal 4/5 IMJ localization showed minimal deviation (− 0.1 ± 0.9 mm).

Conclusion

Ultrasonography enables quantification of PB insertion location and reliable localization of the distal 4/5 IMJ, supporting in vivo assessment of tendon insertion at the fifth metatarsal. LPF assessment is feasible but less robust and more susceptible to misidentification indicating the need for refined scanning protocols, specific operator training. The results of this study provide a foundation for identification of individual anatomical variations in the tendon insertion.