gastrocnemius muscle tear

Etiology: 1) sudden dorsiflexion of the ankle while extending the knee 2) dorsiflexion of the ankle while the foot is planted on the ground Epidemiology: - more common in middle-aged adults Clinical manifestations: 1) mimics acute deep vein thrombosis 2) acute onset of pain in the medial aspect of the midcalf area 3) sensation of being hit in the middle part of the calf 4) swelling develops in the calf & ankle in 24-48 hours 5) blueish discoloration of medial ankle may occur due to downward movement of blood along fascial planes 6) pain occurs while standing or walking 7) eliciting Homan's sign produces pain 8) medial midcalf may be tender Radiology: 1) duplex ultrasound a) assessment of popliteal space b) rules in/out deep vein thrombosis (DVT) 2) magnetic resonance imaging Management: 1) non-weight bearing ambulation (crutches) for 1 week 2) cold compresses for 24-48 hours, followed by heat & use of non-steroidal anti-inflammatory agents (NSAIDs) 3) elastic wrap (ACE bandage) to relieve edema 4) most patients are free of symptoms in 4-6 weeks

Related

calf pain gastrocnemius lower extremity edema

General

traumatic leg injury muscle strain/tear

References

Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998