Type:
Educational Exhibit
Keywords:
Education and training, Education, MR, Musculoskeletal soft tissue, Anatomy
Authors:
S. A. Qureshi1, S. I. Alam2, H. Esmayil2; 1Doha, Qatar/QA, 2Doha/QA
DOI:
10.1594/ecr2018/C-0783
Background
Various Accessory muscles around the ankle are recognized.
Most of them are typically asymptomatic and diagnosed as incidental findings,
but in symptomatic patients they can cause pain,
nerve compression,
compartment syndrome,
or hind foot rigidity.
At times they mimic soft tissue tumors.
Magnetic resonance imaging (MRI) is the modality of choice in diagnosing accessory muscles,
delineating their relationship to adjacent structures and differentiating them from soft tissue tumors.
Accessory muscles are isointense to skeletal muscle on all pulse sequences while soft tissue neoplasms show increased signal intensity on T2WI and STIR.
No treatment is required in asymptomatic patients,
however fasciotomy,
muscle excision or decompression treatments are sought for symptomatic patients.
Accessory muscles of the ankle include the following:
1.
Flexor digitorum accessorius longus (prevalence 2-8%)
2.
Accessory soleus (prevalence 0.7-5.5%)
3.
Accessory peroneal muscles
4.
Peroneocalcaneus internus
5.
Tibiocalcaneus Internus