Proximal medial head gastrocnemius tendon tear and tendinopathy
Presentation
Medial and posterior knee pain. GP thinks patient has medial mensical tear.
Patient Data
Swelling, abnormal T2 signal and longitudonal split (best seen on the coronal) involving the medial gastrocnemius tendon at its origin from the posterior medial femoral condyle. Associated surrounding T2 signal change.
Case Discussion
Significance of tendinopathy and tears in this tendon is unknown. It rarely seems to be symptomatic as compared with the much more common tears in the calf ("tennis leg") at the distal musculo-tendinous junction (that are very painful; attributed to be such by this author!). True tendinopathy should be differentiated from "magic angle" effects given that the tendon curves through the plane of the magnetic field. This is done by looking at effects other than signal increase (ie tendon tears, swelling and surrounding inflammation) as well as the use of longer TE sequences.
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