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Symptomatic accessory soleus muscle: diagnosis and follow-up on magnetic resonance imaging

Department of Diagnostic Radiology, Changi General Hospital, Singapore

View larger version (115K): [in a new window]   Figure 1. Lateral radiograph of the ankle shows a soft tissue mass(arrow) in the region of the Kager's triangle, anterior to the Achilles tendon.

View larger version (91K): [in a new window]   Figure 2. MR images of the ankle.(a) Spin echo T1 weighted axial image shows a soft tissue mass (arrow) of normal muscle signal intensity in an abnormal location, anterior to the Achilles tendon. Surrounding intralipomatous septations are seen. (b) Fast spin echo T2 weighted fat-suppressed axial image shows areas of moderate high signal intensity around this mass, consistent with perimuscular oedema. There is a thin rim of very high signal intensity corresponding to the fascial sheath, representing an intrafascial fluid collection (arrow). (c) Spin echo T1 weighted sagittal image shows the accessory soleus muscle (arrow), corresponding to the soft tissue mass seen on the lateral radiograph.

View larger version (109K): [in a new window]   Figure 3. Follow-up post-treatment MR images obtained 4 months later. (a) Spin echo T1 weighted and (b) fast spin echo T2 weighted fat-suppressed axial images sequences show resolution of the abnormal intrafascial fluid and oedema around the accessory soleus muscle (arrow).