Calf Muscle Injury

52 yr/M presented with painful calf swelling for 3 weeks. He had experienced a sudden & shooting calf pain during a game of badminton.

Ultrasound (US) imaging shows discontinuity of the medial head of gastrocnemius (MHG) muscle fibers at the distal myoaponeurotic junction resulting in a partial thickness tear. A liquified hematoma is seen tracking between the soleus & medial head of gastrocnemius muscle bellies. The Achilles tendon appears intact.

Calf muscle injuries involving the gastrocnemius & soleus muscle bellies is a common athletic injury involving the lower limb. It is characterized by pain & swelling in the calf. This injury is also known as “tennis leg”.

US imaging is a useful tool in the diagnosis and management of muscle tears & ruling out deep venous thrombosis. It can help to identify the exact site (intramuscular, myo-tendinous junction, myofascial junction) of the muscle tear, length of tear, muscle retraction & presence of an associated hematoma. These factors can predict the athlete’s return to play time.