Lateral Soleus Intramuscular Aponeurosis Tear

Monitoring grade II strain injury of the right soleus muscle in a professional football player: it is evident complete strain injury of the lateral aponeurosis involving the middle third of the calf. 

The first examination was made three days after the trauma: 0.3 Tesla MRI

Twenty-eight days after the player is asymptomatic, but what’s about the real situation of the injury? According to recent scientific literature and practical experience, it’s known that a thermal asymmetry above 0,3ºC could show a potential risk of injury due to factors related to workload assimilation, biomechanics, tissue physiology, and nerve dysfunction.

Static and Dynamic Thermography Examination

The study is completed with dynamic B-mode and elastography ultrasound examinations, which show an incomplete scarring formation as expected four weeks after this kind of injury.

Soleus Myotendinous Junction Injury

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.

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

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

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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