Proximal tendon tear of medial head of gastrocnemius

Case contributed by Dr Maulik S Patel

Presentation

Left lower limb residual poliomyelitis. Patient has had left genu recurvatum for past 18 months. Complains of pain, ecchymosis on the posterior aspect of the left knee for past few days.

Patient Data

Age: 50 years
Gender: Male

There is a discontinuity of proximal tendon of medial head of gastrocnemius with retraction of about 50 mm.  The retracted tendon is just below the knee joint. Proximal stump of about 20 mm length is attached to the femur is thickened and hypoechoic. The defect is filled with a collection measuring approximately 25 x 15 x 10 mm. There is overlying subcutaneous edema. The proximal end of the lateral head of gastrocnemius is intact. Distal myotendinous junction of gastrocnemius is intact. There is no deep venous thrombosis. There is no ruptured Baker's cyst.

Case Discussion

An adult male with left lower limb residual poliomyelitis developed genu recurvatum for last few months. He presented with posterior knee swelling and ecchymosis. Ultrasound shows complete tear involving proximal tendon of the medial head of gastrocnemius muscle and tendinotic changes in the proximally attached stump.

Due to genu recurvatum, there was abnormal stress to the proximal tendon of the medial head of the gastrocnemius which tore as the end result, causing posterior knee swelling and ecchymosis.

There is no evidence of tennis leg in this case. 

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Case information

rID: 61865
Published: 21st Jul 2018
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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