Accessory Soleus Muscle: A Problem of Awareness

Abstract

Reports of accessory soleus muscle are rare, perhaps as a result of it often remaining unrecognized. It presents as a swelling behind the ankle and may be mistaken for a tumour or inflammatory lesion, as occurred in the first of a series of three cases. The other two were incidental findings, one in a 30 year old man with an open tibia1 fracture and the other in a 9 month old child with a club foot. Patients present with either pain or a diagnostic problem. When large, it may make wearing of footwear difficult. Computerized tomography with electromyography enables confirmation of the diagnosis. Pain is relieved by epimysiotomy and when encountered incidentally during surgery, incision of the epimysium is all that is needed. Excision of the muscle may be considered only if wearing of footwear is difficult. The significance of its presence in a c h e of club foot is unknown. Disinsertion of its insertion was all that was required to obtain surgical correction of the deformity in the present case. Awareness of the condition will prevent unnecessary surgery in asymptomatic cases.

Accessory soleus muscle in clubfoot deformity: a report in four feet

“…Cut ends of the tibialis posterior tendon (thin arrow) and the flexor digitorum longus tendon (arrowheads) are also seen. is not in the form of any associated deformity, but in the form of a swelling at the posteromedial aspect of the ankle in adolescents or young adults, which is often painful [1,[7][8][9][10]. The pain occurs mostly on activity and these cases are usually diagnosed by imaging studies, of which computed tomography (CT) and magnetic resonance imaging (MRI) are most useful [1,9,10].…”

“…is not in the form of any associated deformity, but in the form of a swelling at the posteromedial aspect of the ankle in adolescents or young adults, which is often painful [1,[7][8][9][10]. The pain occurs mostly on activity and these cases are usually diagnosed by imaging studies, of which computed tomography (CT) and magnetic resonance imaging (MRI) are most useful [1,9,10]. Before the advent of MRI and CT, diagnosis of symptomatic accessory muscle was made only on surgical exploration [4,7,10].…”

“…Muscle anomalies are not commonly associated in patients with idiopathic clubfoot and, when present, their significance is not clear [1]. Encountering accessory soleus muscle in children undergoing surgical release of clubfoot is not a frequent occurrence and only a few reports could be traced in the literature [1][2][3].…”

The accessory soleus muscle causing tibial nerve compression neuropathy: A case report

“…However other smaller series have shown fasciotomy and excision to be equally effective. 1,13 There does seem to be a trend in the literature towards complete excision of the accessory soleus in athletic patients and in general, fasciotomy can be considered for patients with a small accessory soleus or with low activity level and excision for patients with a large accessory muscle and those involved in high level sporting activities.…”

The Accessory Soleus Muscle: Case Report and a Review of the Literature

“…According to Boisgard et al, between 1869 and1995, there were reports of 100 symptomatic cases. The English-language literature has been the principal source of anatomical and clinical records regarding the accessory soleus muscle (Lorentzon & Wirrell, 1987;Chittaranjan et al, 1994;Sekiya et al, 1994;Pla et al;Garg & Kilcoyne;Palaniappan et al;John & Borrelli;Kendi et al;Christodoulo et al;Kouvalchouk et al).…”