Soleus Accessorius: An Uncommon Anatomic Variant of the Calf Muscle

Anatomical variants like the soleus accessorius underscores the incredible diversity within the human body. It serves as a reminder that healthcare professionals should remain vigilant, especially in cases where unexpected structures or variations are encountered during diagnosis or treatment.

Sagittal T2w and T1w – MRI 0.3 Tesla

The soleus accessorius, also known as accessory soleus, is a relatively rare anatomical variant of the calf muscle, the soleus. The soleus muscle is one of the two major muscles in the calf, with the other being the gastrocnemius. The soleus accessorius, when present, is typically an additional muscle belly or slip located adjacent to the primary soleus muscle.

The presence of a soleus accessorius can have clinical significance in several ways:

1. Misdiagnosis: An accessory soleus can be mistaken for a soft tissue mass or other pathology in medical imaging studies, potentially leading to misdiagnosis and unnecessary medical interventions.

2. Functional Impact: In some cases, the soleus accessorius can be associated with altered biomechanics and may contribute to conditions like posterior compartment syndrome, leading to pain and discomfort in the lower leg.

3. Surgical Considerations: Surgeons and orthopedic specialists need to be aware of a soleus accessorius when performing procedures on the calf muscles to avoid accidental damage or complications.

A Thermographic Evaluation of Patellar​ Tendon Partial Tear

about the thermographic evaluation of patellar tendon degeneration

“Many pathological processes in humans manifest themselves as local changes in heat production and also as changes in blood flow pattern at affected organs or tissues”. Vainer BG. FPA-based infrared thermography as applied to the study of cutaneous perspiration and stimulated a vascular response in humans. Phys Med Biol. 2005 Dec 7;50(23): R63–94. 

Since I met the human thermography I always use this kind of evaluation for diagnosis and monitoring of musculoskeletal diseases, together with all the other imaging modalities.

Today I show you the case of a young athlete practicing long jump, with a chronic patellar tendon tendinopathy and partial tear at its proximal attachment.

I always start with clinical examination and thermographic study.

termography-knee

Thermographic study of the painful right knee

termography knee normal

The thermographic evaluation of the healthy left knee shows a difference of 1,5°C less than the right one

Mri Patellar tendon Tendinopathy

Sagittal T1w – Fusion – Stir Mri of the same patient (0.3 Tesla)

I perform the MRI examination to have also the clear depiction of the cortical patellar bone; as you probably know in many similar cases a bone marrow edema is associated at the inferior pole of the patella.

The study is completed with the dynamic ultrasound exam, both in supine and orthostatic position.

The elastosonography evaluation shows less adaptive changes during the dynamic study, as is usually seen in these pathologic conditions.

I believe in integrated imaging study for musculoskeletal pathologies; thermal cameras are user-friendly for anyone is involved in the diagnosis, monitoring, and treatment of these kinds of pathological conditions.