CME OnDemand: 2022 AOFAS Annual Meeting-Accessory Soleus: Posterior Ankle Pain in Two Adolescent Athletes

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Accessory soleus muscles are a rare cause of posterior ankle pain and swelling in adolescent athletes. MRI imaging has become increasingly accessible and helpful in diagnosing and treating this condition. Non-operative treatment options include NSAIDs, physical therapy, and activity modification or observation. However, when non-operative treatment fails, surgical options such as partial fasciotomy or surgical excision of the accessory soleus can be considered.<br /><br />In this case report, two adolescent athletes with posterior ankle pain and swelling caused by accessory soleus muscles were treated with surgical excision. The first case involved a 13-year-old female softball player who experienced posteromedial ankle pain and swelling after playing softball, which limited her pitching to only one inning. The second case involved a 17-year-old male basketball player who had been experiencing posteromedial ankle pain for a year without improvement.<br /><br />In both cases, non-operative treatments were unsuccessful in relieving symptoms, leading to the decision for surgical excision of the accessory soleus. The surgical excision was successful in alleviating the pain and swelling, allowing the athletes to resume their athletic activities without limitations.<br /><br />This case report highlights the rare occurrence of accessory soleus muscles as a source of posterior ankle pain in adolescent athletes. It emphasizes the importance of MRI imaging in diagnosing this condition and the potential effectiveness of surgical excision when non-operative treatments fail. Overall, surgical treatment can be considered as a viable option for relieving symptoms and allowing athletes to return to their rigorous athletic activities.

Asset Subtitle

Hui Zhang, MD, Paul M. Cammack, MD

Keywords

Accessory soleus muscles

posterior ankle pain

swelling

adolescent athletes

MRI imaging

non-operative treatment

surgical options

partial fasciotomy

surgical excision

case report