Dissection of a rare accessory muscle of the leg: The tensor fasciae suralis muscle

Symptomatic tensor fasciae suralis muscle as accessory muscle at popliteal fossa in young soldier: a case report

INTRODUCTION

The tensor fasciae suralis is an aberrant muscle frequently identified in cadaveric studies and MRI studies; however, it has been rarely reported in clinical studies. We present a case of recurrent popliteal pain in a young adult male and our experience with its diagnosis and treatment.

CASE PRESENTATION

A 20-year-old active-duty soldier presented with recurrent right popliteal pain, initially triggered by intense physical activity during military training. Pain subsided with rest but recurred after strenuous exercises, such as soccer. Examination revealed a palpable soft mass with mild tenderness and swelling in the popliteal region. Ultrasonography identified an aberrant tensor fasciae suralis muscle with perifascial edema, originating from the semimembranosus muscle and attaching to the fascia of the medial gastrocnemius. MRI confirmed the findings with edema at its boundary. Conservative management led to symptom improvement. A follow-up ultrasound six months later showed resolution of swelling.

CONCLUSION

This case highlights the importance of recognizing the TFS muscle to avoid misdiagnosis and unnecessary interventions.

Morphological Variability of the Thigh Muscle Traps in an Ultrasound That Awaits Clinicians

Objectives: Muscles and their tendons present a considerable diversity of morphological variations. The aim of this study was to explore variants of muscles and tendons from compartments of the thigh and to raise awareness about potential problems during ultrasound examination. Materials and Methods: This comprehensive review of the literature was created on the basis of scientific articles sourced from PubMed. The search included all relevant papers related to the topic, ensuring that the most up-to-date studies were incorporated. In order to achieve these results, we created the exclusion criteria and extracted papers that did not meet the requirements of our review. Relevant papers were incorporated, and tracking of citations was fulfilled. The described method allowed for a broad yet detailed understanding, ensuring that the review of the literature covers all key aspects of the presented research. Results: Various aspects of thigh muscle anomalies were already undertaken; however, as this study has shown, current knowledge, while valuable, is insufficient to draw definitive conclusions regarding the prevalence and clinical implications of these muscle variations. A more robust body of ultrasound-based research is essential to accurately characterize these anomalies, establish their frequency, and assess their impact on clinical decision-making, including diagnostic accuracy, surgical planning, and therapeutic interventions. Conclusions: Numerous anatomical variations of the thigh muscles and tendons that were described in literature over the years might have clinical implications and could lead to mistakes during diagnosis by ultrasound imaging.

Tensor fasciae suralis - Prevalence study and literature review

Tensor fasciae suralis (TFS) is an accessory muscle of the posterior lower extremity. Although TFS has been documented in cadaveric and radiological reports, its prevalence remains unknown. The TFS variant is noteworthy to anatomists, as it may be encountered in the dissection laboratory, and clinicians, as the muscle could potentially cause confusion during physical examination or diagnostic imaging. Multiple variations of TFS have been reported in the literature, suggesting the need for a classification system. We dissected 236 formalin-fixed cadaveric lower limbs to determine the prevalence of TFS. The PubMed and MEDLINE databases were searched to compare the anatomical features of independent TFS case reports. In our prevalence study, the TFS muscle was identified in three lower limbs (1.3%). In total, 38 cases of TFS (32 cadaveric and six radiological) were identified in the literature. Our literature review revealed that the accessory muscle most often arises as a single head from the long head of the biceps femoris, yet many other presentations have been documented. The need for a classification system to distinguish between the subtypes of TFS became apparent during the literature review. Tensor fasciae suralis is a rare muscle, present in only 3 of 236 (1.3%) cadaveric lower limbs dissected in this study. We propose the use of a classification system, based on muscle origin and number of heads, to better organize the subtypes of TFS.

Impact of plantaris ligamentous tendon

There are countless morphological variations among the muscles, tendons, ligaments, arteries, veins and nerves of the human body, many of which remain undescribed. Anatomical structures are also subject to evolution, many disappearing and others continually emerging. The main goal of this pilot study was to describe a previously undetected anatomical structure, the plantaris ligamentous tendon, and to determine its frequency and histology. Twenty-two lower limbs from 11 adult cadavers (11 left, and 11 right) fixed in 10% formalin were examined. The mean age of the cadavers at death was 60.1 years (range 38–85). The group comprised six women and five men from a Central European population. All anatomical dissections of the leg and foot area accorded with the pre-established protocol. Among the 22 lower limbs, the PLT was present in 16 (72.7%) and absent in six (27.3%). It originated as a strong fan-shaped ligamentous tendon from the superior part of the plantaris muscle, the posterior surface of the femur and the lateral aspect of the knee joint capsule. It inserted to the ilio-tibial band. Histologically, a tendon and ligament were observed extending parallel to each other. A new anatomical structure has been found, for which the name plantaris ligamentous tendon is proposed. It occurs around the popliteal region between the plantaris muscle, the posterior surface of the femur, and the ilio-tibial band.

Additional Attachment of the Semitendinosus and Gracilis Muscles to the Crural Fascia: A Review and Case Illustration

The semitendinosus and gracilis muscles insert primarily onto the superior medial aspect of the tibia. These tendons can be harvested for anterior cruciate ligament reconstruction, and knowledge of their accessory attachments is important for the success of such harvesting procedures. Here, we present a case illustration and review of the attachment of these muscles into the crural fascia (deep fascia of the leg), which is often an underappreciated insertion site.

Tensor Fasciae Suralis Muscle: Report of a Symptomatic Case With Emphasis on Imaging Findings

We report a case of a symptomatic tensor fasciae suralis (TFS) muscle in an elite jumper, with a very rare tear in its origin. The TFS muscle must be recognized and differentiated from other pathologic entities in the popliteal region. The magnetic resonance imaging (MRI) and ultrasound (US) can reliably identify this variant and its pathology.

Bilateral Tensor Fasciae Suralis Muscles in a Cadaver with Unilateral Accessory Flexor Digitorum Longus Muscle

Muscle variants are routinely encountered in the dissection laboratory and in clinical practice and therefore anatomists and clinicians need to be aware of their existence. Here we describe two different accessory muscles identified while performing educational dissection of a 51-year-old male cadaver. Tensor fasciae suralis, a rare muscle variant, was identified bilaterally and accessory flexor digitorum longus, a more common muscle variant, was present unilaterally. Tensor fasciae suralis and accessory flexor digitorum longus are clinically relevant muscle variants. To our knowledge, the coexistence of tensor fasciae suralis and accessory flexor digitorum longus in the same individual has not been reported in either cadaveric or imaging studies.

An abnormal muscle in the superficial region of the popliteal fossa

An abnormal muscle was observed in the superficial region of the popliteal fossa during a dissection procedure conducted for medical students. This abnormal muscle originated from the biceps femoris tendon and inserted into the medial head of the gastrocnemius muscle. The innervating nerve branched from the lateral sural cutaneous nerve. The distributing artery arose from a branch of the sural artery. This abnormal muscle mostly comprised one sheet of muscle mass (not tendon type) and ran transversely.