title: Soleus muscle injury: sensitivity of ultrasound patterns.
abstract: OBJECTIVE
  To assess the sensitivity of ultrasound in detecting soleus muscle lesions diagnosed on magnetic resonance imaging (MRI) and to characterize their location, ultrasound pattern, and evolution.
  
  
  METHODS
  Ultrasound and MRI studies were performed between May 2009 and February 2013 on all patients who presented to the Medical Services Clinic of the Catalan Sport Council with the initial onset of sharp pain in the calf compatible with injury of the soleus muscle. An inter-observer ultrasound reliability study was also performed.
  
  
  RESULTS
  A total of 55 cases of soleus injury were studied prospectively (22 with right leg involvement, 33 left) by ultrasound and MRI, which was utilized as the "gold standard." In MRI studies, 24 cases (43.7%) had myofascial injuries that were localized in the posterior aponeurosis (PMF) in 15 cases (27.3%) and in the anterior aponeurosis (AMF) in 9 (16.4%). Thirty-one cases (56.3%) were musculotendinous injuries, with 9 cases (16.4%) in the medial aponeurosis (MMT), 11 cases (20%) in the lateral aponeurosis (LMT), and 11 cases (20%) in the central tendon (CMT). In comparison to MRI, ultrasound was able to detect injury to the soleus in 27.2% of cases. No injuries were detected by ultrasound alone. Posterior myofascial injuries were more likely to be detected by ultrasound than anterior myofascial injuries or all types of musculotendinous injuries. Ultrasound patterns for each type of injury were described.
  
  
  CONCLUSIONS
  Ultrasound is not a sensitive technique for detecting and assessing soleus traumatic tears compared with MRI, although the sensitivity is enhanced by a thorough anatomically based ultrasound examination. Timing of the ultrasound examination may be of importance. Each type of soleus injury appears to have a characteristic ultrasound pattern based on a defect of connective expansions, the existence of small myofascial filiform collections, and the rarefaction of the fibrillar area.
authors.affiliation: Sport Catalan Council, Generalitat de Catalunya, Barcelona, Spain.
authors.forename: Ramon
authors.initials: R
authors.lastname: Balius
authors.forename: Gil
authors.initials: G
authors.lastname: Rodas
authors.forename: Carles
authors.initials: C
authors.lastname: Pedret
authors.forename: Lluís
authors.initials: L
authors.lastname: Capdevila
authors.forename: Xavier
authors.initials: X
authors.lastname: Alomar
authors.forename: David A
authors.initials: DA
authors.lastname: Bong
mesh_terms: D000328:Adult; D001265:Athletic Injuries / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007869:Leg Injuries / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D009104:Multiple Trauma / Q000000981:diagnostic imaging* / Q000473:pathology; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging* / Q000293:injuries*; D017695:Soft Tissue Injuries / Q000000981:diagnostic imaging* / Q000473:pathology; D013708:Tendon Injuries / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography / Q000379:methods