Accessory soleus muscle as a cause of chronic calf pain

Abstract

The patient, a 35-year-old man, had developed severe pain and mild swelling in the left lower leg and ankle 8 weeks prior to presentation. He had no history of trauma, fever, rash, insect bites, eating raw meat, or exposure to animals. He did have a history of chronic bilateral knee pain, but the etiology had never been determined. His leg was placed in a short-leg cast for 4 weeks, with no relief of symptoms. Subsequently, he noted significant improvement with physiotherapy and nonsteroidal antiinflammatory drugs. Physiotherapy consisted of exercise on a balance board, stretches, and ultrasound treatment.The earlier medical history included 2 groin surgeries, in 1988 and 1989, for perineal trauma resulting from a fall on a log in military basic training. A scrota1 ultrasound examination and retrograde urethrography had been performed at that time, but no radiographs were obtained. During the past several years he had undergone physiotherapy for bilateral knee pain.Physical examination revealed a mildly tender mass in the medial and posterior aspect of the left lower leg and ankle. Neurovascular function was intact. Range of motion and strength of the left ankle were normal. Laboratory studies showed normal findings on tests of creatinine and cholesterol levels, liver function tests, complete blood cell count, and blood chemistry panel. Radiologic findingsFindings of standard radiographs of the left leg and ankle were normal. Axial proton-density-weighted

Accessory Soleus Muscle as a Cause of Resistance to Correction in Congenital Club Foot: A Case Report

“…The patients with an accessory Soleus muscle may be asymptomatic 12,13 , but 67% present as a painful swelling at the posteromedial aspect of the ankle, usually presenting at approximately 20 years of age 4 . The diagnosis can be confirmed by using EMG 6,14,20 , ultrasound 22 , CT scan 4,6 , or MRI 5,11,20,24,8,10,16 . It is difficult to differentiate it from a soft tissue tumor 23 and an exploratory biopsy has been performed to confirm the diagnosis 19,22 .…”

Músculo Soleo Accesorio: Presentación De Un Caso Y Revisión De La Bibliografía

“…La primera descripción anatómica la realizó Cruvelhier, en 1843 y la primera referencia bibliográfica Dunn en 1965 (5) , habiéndose descrito muy pocos casos en la bibliografía, no llegando prácticamente al centenar (1,2,3) . Normalmente es unilateral, pudiendo ser bilateral (6,7,8) . Presentamos un caso y revisamos la bibliografía por lo inhabitual de esta variante y porque, al igual que algunos autore (4,9) , pensamos que si bien las imágenes son características, el desconocimiento o la ausencia de familiaridad con la entidad pueden hacer que no se diagnostique o sea confundida con un tumor de partes blandas.…”

The Accessory Soleus Muscle: Case Report and a Review of the Literature

“…Dunn highlighted the clinical significance of the accessory soleus muscle and, subsequent to that work, the anatomical and orthopedic literature became enriched with several other clinical records of its occurrence (Gordon & Matheson, 1973;Ayala et al, 1982;Percy & Telep, 1984;Romanus et al, 1986;Petterson et al;Lorentzon & Wirell;Vanek & Fourré;Motto & Holloway;Pla et al;Garg & Kilcoyne;Palaniappan et al;Chotigavanichaya et al, 2000;Dos Remédios & Jolly, 2000;Kendi et al;Kouvalchouk et al).…”

“…Dunn (1965) was the first to demonstrate that the accessory soleus muscle was involved in painful syndromes of the lower limbs. These syndromes may occur in the calf (Garg & Kilcoyne, 1997), ankle (Vanek & Fourré, 1993) and leg (Pla et al, 1996). Downey et al (1996) conducted a review of the literature, taking into consideration a 30-year period starting in 1965, and reported the occurrence of 70 cases.…”

“…According to Boisgard et al, between 1869 and1995, there were reports of 100 symptomatic cases. The English-language literature has been the principal source of anatomical and clinical records regarding the accessory soleus muscle (Lorentzon & Wirrell, 1987;Chittaranjan et al, 1994;Sekiya et al, 1994;Pla et al;Garg & Kilcoyne;Palaniappan et al;John & Borrelli;Kendi et al;Christodoulo et al;Kouvalchouk et al).…”