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Aim. The aim of this paper was to investigate the prevalence and sports distribution in athletes.
Methods. Six hundred and fifty radiographs of athletes affected by tenderness and exertional pain in the region of the Achilles tendon, were observed over a period of 30 years. The clinical and diagnostic imaging materials were reviewed.
Results. Eighteen cases of accessory symptomatic soleus muscle were diagnosed: in 10 cases using soft tissue radiographic technique, in 8 cases using, in sequence, exclusively ultrasound and magnetic resonance.
Conclusion. The presence of an accessory soleus muscle has been considered a rare even incidental occurrence; the review of our cases, substantially different for the evident symptoms, showed a frequency in athletes of 2.77% in accordance with the results of the anatomical and clinical literature. US and MRI are the best diagnostic modalities especially in differentiating accessory soleus muscle from soft tissue tumors not rare in this anatomic region.
KEY WORDS: Accessory soleus muscle - Sports - Injuries.
Disorders of the Achilles tendon are the most common overuse injuries associated with athletic competitions and recreational activities.
Less common disorders causing pain in the hindfoot which are, i.e. retrocalcaneal bursitis, or tarsal tunnel entrapment neuropathy.1
Among these less common clinical events, the occurrence of a symptomatic "anomalous soleus muscle", has been described as a cause of a mass in the postero-medial aspect of the ankle becoming more marked in volume and pain during or after strenuous athletic performances.2-8
The accessory soleus muscle, sometimes in association with a varus and equinus tendency of the foot, can be unilateral, rarely bilateral and in this case always asymmetric in volume 9 (Figures 1A, B).
The proximal insertion is in front of the normal soleus muscle, constantly situated along the soleus body, anteriorly and within Achilles tendon and plantaris muscle.
The distal insertion in contrast is inconstant and variable; 5 types have been described: by a muscular or tendinous band into the Achilles tendon itself, on the upper surface of calcaneus or by a long tendon into the medial aspect of calcaneus, rarely by a bifid tendon into both surfaces of the calcaneus.
This accessory muscle is enveloped within its own fascia and has 1 or 2 neurovascular bundles coming from the posterior tibial artery and nerve....