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Accessory soleus muscle

Case contributed by Ali Alsmair
Diagnosis certain

Presentation

History of trauma with ankle pain and swelling. To exclude soft tissue injury.

Patient Data

Age: 55 years
Gender: Female
mri

An accessory soleus muscle is noted, it obliterates the Kager fat pad, and inserts into the posteromedial aspect of the calcaneus.
Linear fracture of the anterior talar process with surrounding bone marrow edema.
Edematous changes of the sinus tarsi replacing sinus fat, suggesting sinus tarsi syndrome.
Bone marrow edema of the calcaneus is also noted.
Tear of the anterior talofibular ligament.
A calcaneal spur is noted.
Partial tear of the tibialis anterior tendon.
Fluid surrounding the flexor hallucis longus at the level of Knot of Henry, suggesting tenosynovitis.
Diffuse subcutaneous edema around the ankle.
Minimal retrocalcaneal fluid (retrocalcaneal bursitis), with prominence of the posterosuperior aspect of the calcaneus (Haglund deformity) and mild edematous changes of the Achilles tendon, suggesting Haglund syndrome.
Thickening and increased signal intensity of the deltoid ligament, suggesting sprain, without tear.
 

Case Discussion

This was an incidental finding and was not diagnosed before. The patient has no complaint before the trauma.

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