Anatomic Insights Into Lateral Intersection Syndrome in the Foot and Ankle

Abstract

Lateral intersection syndrome, or fibularis intersection syndrome, is an uncommon overuse condition affecting the lateral aspect of the foot involving the intersection of the peroneus longus and brevis tendons. While intersection syndromes have been described in other anatomic locations, such as the wrist and medial foot/ankle, this pathology remains underreported. This cadaveric study aimed to establish baseline anatomical measurements relevant to lateral intersection syndrome. Eight thawed fresh-frozen cadaveric lower limbs, 4 matched pairs, were dissected, and measurements of key lateral foot structures were recorded, including plantar fascia width, peroneus brevis width, the distance between the peroneus brevis and the plantar fascia, and the distance between the cuboid groove and the fifth metatarsal. The average (mean) plantar fascial width was 4.99 mm, whereas the peroneus brevis width averaged 6.64 mm. A notable laterality difference was identified, with right-sided specimens consistently showing larger measurements compared with the left. Limitations include a small sample size and the use of cadaveric models, which may not replicate in vivo tissues. This study serves as a foundational reference for further research into lateral intersection syndrome and highlights the need for increased clinical recognition of the pathology.

Levels of evidence: Level IV Cadaveric Study