Tibiocalcaneus internus muscle
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The tibiocalcaneus internus muscle is a rare accessory muscle of the ankle and an anatomical variant with an unknown prevalence.
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Summary
- origin: medial crest of the lower third of the tibia
- insertion: medial surface of the calcaneus approximately 1-2 cm anterior to the Achilles tendon
Gross anatomy
The tibiocalcaneus internus muscle travels from the posterior medial tibial surface of the lower leg to the medial surface of the calcaneus near the calcaneal tuberosity deep in the flexor retinaculum within the tarsal tunnel 1-3. It runs posterior to the neurovascular bundle and posteromedially to the flexor hallucis longus muscle and tendon and posterolateral to the flexor digitorum longus muscle 2-4.
Radiographic features
MRI
The tibiocalcaneus internus muscle looks like ordinary muscle and can be identified on MRI of the ankle by its course and location posterior to the neurovascular bundle flexor hallucis longus and flexor digitorum longus musculotendinous units within the flexor retinaculum and its insertion site at the posterior medial calcaneal surface 2-4.
Clinical importance
The tibiocalcaneus internus muscle can be mistaken for an accessory soleus muscle or a flexor digitorum accessorius longus muscle, it might be also mistaken for pathology 1-3.
Related pathology
The tibiocalcaneus internus muscle can potentially cause tarsal tunnel syndrome 1-3.
References
- 1. Aparisi Gómez M, Aparisi F, Bartoloni A et al. Anatomical Variation in the Ankle and Foot: From Incidental Finding to Inductor of Pathology. Part I: Ankle and Hindfoot. Insights Imaging. 2019;10(1):74. doi:10.1186/s13244-019-0746-2 - Pubmed
- 2. Aparisi Gómez M, Aparisi F, Bartoloni A et al. Anatomical Variation in the Ankle and Foot: From Incidental Finding to Inductor of Pathology. Part II: Midfooot and Forefoot. Insights Imaging. 2019;10(1):69. doi:10.1186/s13244-019-0747-1 - Pubmed
- 3. Al-Himdani S, Talbot C, Kurdy N, Pillai A. Accessory Muscles Around the Foot and Ankle Presenting as Chronic Undiagnosed Pain. An Illustrative Case Report and Review of the Literature. The Foot. 2013;23(4):154-61. doi:10.1016/j.foot.2013.08.002 - Pubmed
- 4. Cheung Y. Normal Variants: Accessory Muscles About the Ankle. Magn Reson Imaging Clin N Am. 2017;25(1):11-26. doi:10.1016/j.mric.2016.08.002 - Pubmed
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