Accessory Soleus Muscle: Two Case Reports with a Completely Different Presentation Caused by the Same Entity

Accessory soleus muscle (ASM) is a rare supernumerary anatomical variant that commonly presents as a posteromedial ankle swelling, which may become painful during physical activity. As it may mimic a soft tissue tumor, it is essential to differentiate this condition from ganglion, lipoma, hemangioma...

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Main Authors: Mihovil Plečko, Igor Knežević, Damjan Dimnjaković, Mario Josipović, Ivan Bojanić
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Case Reports in Orthopedics
Online Access:http://dx.doi.org/10.1155/2020/8851920
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author Mihovil Plečko
Igor Knežević
Damjan Dimnjaković
Mario Josipović
Ivan Bojanić
author_facet Mihovil Plečko
Igor Knežević
Damjan Dimnjaković
Mario Josipović
Ivan Bojanić
author_sort Mihovil Plečko
collection DOAJ
description Accessory soleus muscle (ASM) is a rare supernumerary anatomical variant that commonly presents as a posteromedial ankle swelling, which may become painful during physical activity. As it may mimic a soft tissue tumor, it is essential to differentiate this condition from ganglion, lipoma, hemangioma, synovioma, and sarcoma. However, ASM may also present with a painful syndrome, characterized by pain and paresthesia of the ankle and foot, mimicking the tarsal tunnel syndrome (TTS). Two cases of ASM are presented in this article. The first case had a typical presentation with painful posteromedial ankle swelling. After the initial assessment, the diagnosis was confirmed by magnetic resonance imaging (MRI), and ASM was treated by complete resection. The second case presented with pain and paresthesia in the right ankle and foot, but no swelling was noticeable. It was initially misdiagnosed by a rheumatologist and afterward overlooked on an MRI by a musculoskeletal radiology specialist and therefore mistreated by numerous physicians before being referred to our outpatient clinic. After further assessment, the diagnosis has been confirmed, and ASM was treated by complete resection combined with tarsal tunnel decompression. To the best of our knowledge, this is the first case reported in which ASM caused symptoms but presented without posteromedial swelling. This might be due to a proximally positioned belly of the ASM, followed by a tendinous insertion on the medial side of the calcaneus.
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spelling doaj-art-60c737ba956a47a7a558abbd720a9f6a2025-08-20T03:34:56ZengWileyCase Reports in Orthopedics2090-67492090-67572020-01-01202010.1155/2020/88519208851920Accessory Soleus Muscle: Two Case Reports with a Completely Different Presentation Caused by the Same EntityMihovil Plečko0Igor Knežević1Damjan Dimnjaković2Mario Josipović3Ivan Bojanić4Department of Orthopaedic Surgery, University Hospital Centre Zagreb, Šalata 6-7, 10 000 Zagreb, CroatiaDepartment of Orthopaedic Surgery, University Hospital Centre Zagreb, Šalata 6-7, 10 000 Zagreb, CroatiaDepartment of Orthopaedic Surgery, University Hospital Centre Zagreb, Šalata 6-7, 10 000 Zagreb, CroatiaDepartment of Orthopaedic Surgery, University Hospital Centre Zagreb, Šalata 6-7, 10 000 Zagreb, CroatiaDepartment of Orthopaedic Surgery, University Hospital Centre Zagreb, Šalata 6-7, 10 000 Zagreb, CroatiaAccessory soleus muscle (ASM) is a rare supernumerary anatomical variant that commonly presents as a posteromedial ankle swelling, which may become painful during physical activity. As it may mimic a soft tissue tumor, it is essential to differentiate this condition from ganglion, lipoma, hemangioma, synovioma, and sarcoma. However, ASM may also present with a painful syndrome, characterized by pain and paresthesia of the ankle and foot, mimicking the tarsal tunnel syndrome (TTS). Two cases of ASM are presented in this article. The first case had a typical presentation with painful posteromedial ankle swelling. After the initial assessment, the diagnosis was confirmed by magnetic resonance imaging (MRI), and ASM was treated by complete resection. The second case presented with pain and paresthesia in the right ankle and foot, but no swelling was noticeable. It was initially misdiagnosed by a rheumatologist and afterward overlooked on an MRI by a musculoskeletal radiology specialist and therefore mistreated by numerous physicians before being referred to our outpatient clinic. After further assessment, the diagnosis has been confirmed, and ASM was treated by complete resection combined with tarsal tunnel decompression. To the best of our knowledge, this is the first case reported in which ASM caused symptoms but presented without posteromedial swelling. This might be due to a proximally positioned belly of the ASM, followed by a tendinous insertion on the medial side of the calcaneus.http://dx.doi.org/10.1155/2020/8851920
spellingShingle Mihovil Plečko
Igor Knežević
Damjan Dimnjaković
Mario Josipović
Ivan Bojanić
Accessory Soleus Muscle: Two Case Reports with a Completely Different Presentation Caused by the Same Entity
Case Reports in Orthopedics
title Accessory Soleus Muscle: Two Case Reports with a Completely Different Presentation Caused by the Same Entity
title_full Accessory Soleus Muscle: Two Case Reports with a Completely Different Presentation Caused by the Same Entity
title_fullStr Accessory Soleus Muscle: Two Case Reports with a Completely Different Presentation Caused by the Same Entity
title_full_unstemmed Accessory Soleus Muscle: Two Case Reports with a Completely Different Presentation Caused by the Same Entity
title_short Accessory Soleus Muscle: Two Case Reports with a Completely Different Presentation Caused by the Same Entity
title_sort accessory soleus muscle two case reports with a completely different presentation caused by the same entity
url http://dx.doi.org/10.1155/2020/8851920
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