Accessory Tibionavicular Muscle: An Unusual Cause of Medial Ankle Pain

Abstract

Accessory or anomalous muscles around the ankle are not uncommon and are usually asymptomatic. They are traditionally encountered during imaging undertaken for evaluation of ankle pain. We reported the first case of a new accessory muscle in the anteromedial part of the ankle with associated partial thickness tear in an 18-year-old football player presenting as symptomatic pathology. In this article, we described the role of cross-sectional imaging in its diagnosis including successful management of the condition with ultrasound-guided platelet-rich plasma therapy and review-associated literature.

Keywords

ankle - accessory muscles - ultrasound - magnetic resonance imaging - platelet-rich plasma - dry needling

Publikationsverlauf

Artikel online veröffentlicht:
01. Juni 2023

• References

• 1 Sookur PA, Naraghi AM, Bleakney RR, Jalan R, Chan O, White LM. Accessory muscles: anatomy, symptoms, and radiologic evaluation. Radiographics 2008; 28 (02) 481-499
• 2 Cheung Y. Normal variants: accessory muscles about the ankle. Magn Reson Imaging Clin N Am 2017; 25 (01) 11-26
• 3 Ettehadi H, Saragas NP, Ferrao P. A rare case of flexor digitorum accessorius longus muscle presenting as tarsal tunnel syndrome. Arch Bone Jt Surg 2022; 10 (01) 112-116
• 4 Al-Himdani S, Talbot C, Kurdy N, Pillai A. Accessory muscles around the foot and ankle presenting as chronic undiagnosed pain. An illustrative case report and review of the literature. Foot 2013; 23 (04) 154-161
• 5 Duran-Stanton AM, Bui-Mansfield LT. Magnetic resonance diagnosis of tarsal tunnel syndrome due to flexor digitorum accessorius longus and peroneocalcaneus internus muscles. J Comput Assist Tomogr 2010; 34 (02) 270-272
• 6 Howe BM, Murthy NS. An accessory peroneocalcaneus internus muscle with MRI and US correlation. J Radiol Case Rep 2012; 6 (10) 20-25
• 7 Hur MS, Won HS, Oh CS, Chung IH, Lee WC, Yoon YC. Classification system for flexor digitorum accessorius longus muscle variants within the leg: clinical correlations. Clin Anat 2014; 27 (07) 1111-1116
• 8 Aparisi Gómez MP, Aparisi F, Bartoloni A. et al. Anatomical variation in the ankle and foot: from incidental finding to inductor of pathology. Part I: ankle and hindfoot. Insights Imaging 2019; 10 (01) 74
• 9 See PL. You can never have too many accessories - a case of two accessory muscles of the ankle. Med J Malaysia 2016; 71 (04) 199-200
• 10 Mellado JM, Rosenberg ZS, Beltran J, Colon E. The peroneocalcaneus internus muscle: MR imaging features. AJR Am J Roentgenol 1997; 169 (02) 585-588
• 11 Berkowitz Y, Mushtaq N, Amiras D. MRI of the tibioastragalus anticus of Gruber muscle: a rare accessory muscle and normal anatomical variant. Skeletal Radiol 2016; 45 (06) 847-849
• 12 Chinzei N, Kanzaki N, Takakura Y. et al. Surgical management of the peroneus quartus muscle for bilateral ankle pain: a case report. J Am Podiatr Med Assoc 2015; 105 (01) 85-91
• 13 Crim J. Medial-sided ankle pain: deltoid ligament and beyond. Magn Reson Imaging Clin N Am 2017; 25 (01) 63-77
• 14 Kakarala CL, Iyengar KP, Beale D, Botchu R. Isolated tear of the tibionavicular component of the superficial deltoid ligament: unusual cause of medial ankle pain. BMJ Case Rep 2022; 15 (06) e251287
• 15 Rodríguez-Merchán EC, Moracia-Ochagavía I. Tarsal tunnel syndrome: current rationale, indications and results. EFORT Open Rev 2021; 6 (12) 1140-1147
• 16 Setayesh K, Villarreal A, Gottschalk A, Tokish JM, Choate WS. Treatment of muscle injuries with platelet-rich plasma: a review of the literature. Curr Rev Musculoskelet Med 2018; 11 (04) 635-642
• 17 Grassi A, Napoli F, Romandini I. et al. Is platelet-rich plasma (PRP) effective in the treatment of acute muscle injuries? A systematic review and meta-analysis. Sports Med 2018; 48 (04) 971-989