Skeletal Radiology

, Volume 43, Issue 6, pp 805–812 | Cite as

Soleus muscle injury: sensitivity of ultrasound patterns

  • Ramon Balius
  • Gil Rodas
  • Carles PedretEmail author
  • Lluís Capdevila
  • Xavier Alomar
  • David A. Bong
Scientific Article



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.

Materials and 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.


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.


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.


Soleus Ultrasound MRI Muscle injury 


Conflict of interest


Ethics approval

Ethics approval was obtained from the Consell Català de l’Esport.


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Copyright information

© ISS 2014

Authors and Affiliations

  • Ramon Balius
    • 1
    • 2
  • Gil Rodas
    • 3
  • Carles Pedret
    • 2
    • 4
    • 5
    Email author
  • Lluís Capdevila
    • 6
  • Xavier Alomar
    • 7
  • David A. Bong
    • 8
  1. 1.Sport Catalan Council, Generalitat de CatalunyaBarcelonaSpain
  2. 2.Clínica CMI DiagonalBarcelonaSpain
  3. 3.F.C. Barcelona Medical ServicesBarcelonaSpain
  4. 4.Sports Medicine and Imaging DepartmentClínica Mapfre de Medicina del TenisBarcelonaSpain
  5. 5.Centre de Diagnòstic per Imatge de TarragonaTarragonaSpain
  6. 6.Laboratory of Sport PsychologyUniversitat Autònoma de BarcelonaBarcelonaSpain
  7. 7.Clínica Creu BlancaBarcelonaSpain
  8. 8.Instituto Poal de ReumatologiaBarcelonaSpain

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