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Clinical Image - International Journal of Clinical & Medical Images (2024) Volume 11, Issue 3
Author(s): Marrakchi Salma*, Laasri Khadija, Hadj Hsain Ihssan, El Yousfi Zakia, El Fenni Jamal, En-nouali Hassan
Department of Radiology, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
Received: 27 October 2023, Manuscript No. ijcmi-23-118599; Editor assigned: 28 October 2023, Pre QC No. P-118599; Reviewed: 15 March 2024, QC No. Q-118599; Revised: 21 March 2024, Manuscript No. R-118599; Published: 29 March 2024, DOI:10.4172/2376-0249.1000947
Citation: Salma M, Khadija L, Ihssan HH, Zakia EY and Jamal EIF, et al. (2024) “Tennis Leg”, When Ultrasound can make the Diagnosis. Int J Clin Med Imaging 11: 947.
Copyright: © 2024 Salma M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
“Tennis leg” is a myofascial or tendinous injury of the lower limb It refers to acute mid-calf pain, with a sensation “snapping” within the calf. The diagnosis can be made with ultrasound. The main finding on ultrasonography is the existence of fluid between medial gastrocnemius and soleus muscle, most prominent at the level of the myotendinous junction.
“Tennis leg” is a myofascial or tendinous injury of the lower limb [1] which was first described in a tennis player in 1883, but it can occur during many activities [2].
It refers to acute mid-calf pain, which typically occurs in active individuals, more frequently in middle-aged individuals.
The most frequent biomechanical causes of the injury are extension of the knee and forced dorsiflexion of the ankle [3].
It was attributed to rupture of the plantaris tendon [4]. Although rupture of the plantaris is possible, injury to the medial head of the gastrocnemius or injury to the gastrocnemius-soleus aponeurosis are far more common causes of tennis leg [2].
Clinically, it is felt as an acute mid-calf pain with a sensation “snapping” within the calf which can be heard by the patient. This is associated with focal tenderness and swelling, with sometimes a focal gap at the site of the tear [4] Which can be masked later by swelling.
The main finding on ultrasonography is the existence of fluid deep to medial gastrocnemius and superficial to the soleus muscle, most prominent at the level of the myotendinous junction (Figure 1) without evidence of muscle rupture.
A tear in the deep surface of gastrocnemius may be seen as a disruption in contour and echogenicity of muscle fibers [1].
The differential diagnosis in case of calf pain and swelling, can be made with deep vein thrombosis which may coexist with “Tennis leg”, and also with a ruptured Baker cyst [1].
Ultrasonography with B-mode and Doppler-mode is sufficient to make the diagnosis of “Tennis leg”, and rule out differential diagnoses.
Treatment is usually conservative and the condition self-limiting. Only in cases where severe swelling leads to compartment syndrome is surgical fasciotomy necessary.
Ultrasound examination showed a fluid collection between the medial head of the gastrocnemius (G) and soleus (S) muscles without evidence of muscle rupture.
Tennis leg; Gastrocnemius muscle; Soleus muscle
None.
There is no conflict of interest.
[1] Gaillard F, Shaggah M and Bawazeer A. Tennis leg.
[2] Harwin, J. R., and Richardson, M. L. (2017). “Tennis leg”: gastrocnemius injury is a far more common cause than plantaris rupture. Radiol Case Rep 12(1): 120-123.
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[3] Delgado GJ, Chung CB, Lektrakul N, Azocar P and Botte MJ, et al. (2002). Tennis leg: clinical US study of 141 patients and anatomic investigation of four cadavers with MR imaging and US. Radiol 224(1): 112-119.
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