About aponeurotic medial insertion injury of the soleus muscle.

Knowing the anatomy and biomechanics of the gastrocnemius-soleus complex – or triceps surae – is crucial for an understanding of the etiology and treatment of all its possible injuries. Today I want to show you a painful partial lesion at the aponeurotic medial insertion of the soleus muscle in a professional soccer player.

One month after a soleus injury, a patient suffered for pain and discomfort at the distal soleus myotendinous junction; first examination was made with an ultraportable device directly on the pitch during a daily training session. A partial injury of the aponeurotic medial insertion was evident, togheter with muscle perilesional edema.

Sagittal Ultrasound comparative examination of the medial soleus myotendinous junction; normal findings on the right side.

Sagittal GeStir (left) and Coronal T2w Mri scans of the same patient (0.3 Tesla).

Axial (left) and Sagittal (right) T2w Mri scans (0.3 Tesla).

With the dynamic ultrasound examination is better appreciated also an inflammation along the course of the posterior tibial nerve.

Also in this case the elastosonography evaluation works like a “contrast agent” well depicting the lesional area.

You can find further information about the complex anatomy of the triceps surae in this interesting scientific paper: Anatomy of the Triceps Surae: A Pictorial Essay