Diagnosis and Follow-up US Evaluation of Ruptures of the Medial Head of the Gastrocnemius ("Tennis Leg")

Kwak, Hyo Sung; Han, Young Min; Lee, Sang Yong; Kim, Ki Nam; Chung, Gyung Ho

doi:10.3348/kjr.2006.7.3.193

Cited by 50 publications

(73 citation statements)

References 13 publications

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“…Speaking of the size of the lesion, Kwak et al 16 reported that the largest dimension of the liquid collection after injury in the gastrocnemius muscle was 125mm 16 while we found the collections sized up to 52mm. Previous research by the same group reported larger diameter of liquid collections 17 .…”

Section: Discussioncontrasting

confidence: 40%

“…Also, none of the patients were hospitalized and all of them were treated conservatively. Kwak et al 16 underlines in his paper that all of the patients with rupture of the medial head of the gastrocnemius muscle were hospitalized for one to four days. In our research we found that all patients were treated with different types of immobilization regardless of the type of lesion.…”

Section: Discussionmentioning

confidence: 99%

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Ultrasonographic Evaluation of the Ruptured Medial Head of Gastrocnemius Muscle

Lukac

Jakovljević

Klasnja

et al. 2016

Rev Bras Med Esporte

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Introduction: Tennis leg, a common injury of the medial head of gastrocnemius muscle in the muscle-tendon junction, is usually reported in men during recreational sports. Sudden pain is the main symptom accompanied by the feeling of rupture in the calf. Clinical examination followed by ultrasound is the standard diagnostic procedure. Objective: The main objectives of this study are to compare clinical and ultrasonographic findings in cases of tennis leg, evaluate the location and type of lesion in the medial head of gastrocnemius muscle, and evaluate the edema volume and the presence of deep vein thrombosis (DVT). Second, the healing process was monitored with ultrasound to distinguish the level of recovery and to record the presence of chronic sequelae. Methods: Eighty-one subjects with clinical symptoms of rupture of the medial head of gastrocnemius muscle participated in the study. A linear probe (7-12 MHz) was used for ultrasonographic (US) and a Doppler was used to verify the presence of DVT. Results: In 78 of 81 subjects examined, we found obvious US changes (96.3%) and three of them had no positive findings. In 67 of them, we diagnosed rupture of the medial head of the gastrocnemius muscle. Most of them had partial rupture (73.13%) and the remaining had total rupture (26.87%). The edema (30.84%) was found in the space between the aponeurosis of the gastrocnemius and soleus muscles. DVT with the clinical signs of tennis leg was observed in 5 of 81 patients (6.17%). Conclusion: Our findings indicate that ultrasound is very important for early diagnosis of muscle-tendon injuries in the leg. In addition, monitoring the healing process and assessing the chosen treatment showed a high efficiency. Ultrasonography is an effective method to identify and differentiate the sequelae of the injured muscles and vascular complications.

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Section: Discussioncontrasting

confidence: 40%

Section: Discussionmentioning

confidence: 99%

Ultrasonographic Evaluation of the Ruptured Medial Head of Gastrocnemius Muscle

Lukac

Jakovljević

Klasnja

et al. 2016

Rev Bras Med Esporte

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“…The most common mechanism of rupture is dorsiflexion of the ankle with knee in full extension which results in simultaneous active contraction and passive stretching of the muscle 2. It is very common in tennis players and hence the term ‘tennis leg’ was coined by Powell3.…”

Section: Discussionmentioning

confidence: 99%

Plantaris rupture: why is it important?

Rohilla

Jain²,

Yadav

2013

BMJ Case Reports

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Plantaris muscle is accessory plantar flexor of calf, a vestigial muscle of triceps surae complex. Its importance lies in the fact that its rupture cans mimic deep vein thrombosis (DVT). Sometimes when there is rupture of Achilles tendon, intact plantaris can still cause plantar flexion at ankle presenting a confusing picture. We present one such case of plantaris rupture confused by radiology resident with DVT. A 51-year-old man had a feeling as if kicked in back of calf along with a snapping sound and severe pain while playing tennis. On seeing fluid between muscle plane and a hypoechoic structure radiology resident labelled it DVT. MRI suggested ruptured plantaris as fluid and muscle stump were seen between gastronemius and soleus. Patient was treated conservatively with rest, ice compression and elevated leg and showed significant reduction in pain and swelling.

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“…Most authors recommend the use of rest, ice, compression and elevation immediately following injury followed by passive stretching exercises and isometric strengthening rehabilitation until full intensity sports can be resumed [11,12] . Ultrasound follow-up has even demonstrated primary union at the rupture site, taking place as early as 4 weeks after the initial injury, following conservative measures only [13] . Cases of surgical management of tennis leg are scarce within the literature.…”

Section: Discussionmentioning

confidence: 99%