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Patients or Programs:A 15-year-old female high school basketball player. Program Description: A 15-year-old female basketball player who was referred for the evaluation of left calf pain and swelling. She reported a remote ankle and calf injury that occurred several years ago but no recent trauma. Setting: Outpatient academic sports medicine clinic. Results: The circumference of the left leg at the level of the gastrocnemius muscle was measured at 15.25 inches, and the right was measured at 14 inches. The remainder of the clinical examination was unremarkable except for tenderness to palpation over the medial gastrocnemius muscle. A musculoskeletal ultrasound study was performed, which revealed a disorganized mass of mixed echogenicity within the medial head of the left gastrocnemius muscle. Multiple hyperechoic foci were seen without discernible muscle structure. A vascular ultrasound study of her leg was negative for a deep venous thrombosis, but a magnetic resonance imaging of the left lower leg revealed a large heterogenous, mildly enhancing mass that replaced the entire medial head of the left gastrocnemius muscle. She was referred to surgery, and an angiogram and a biopsy were performed, which confirmed the findings of an intramuscular hemangioma.

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