Gastrocnemius Injury

Abstract

Pediatric patients presenting with acute onset posterior knee pain may have an avulsion injury of the medial gastrocnemius muscle at its origin or in the first few centimeters of the tendon. This injury is rare, but understanding the key elements of the patient history, the anatomy, and the typical recovery pattern is useful in the evaluation and management of posterior knee pain (Gottsegen et al., Radiographics 28(6):1755–1770, 2008; Maehara and Sakaguchi, JBJS Case Connect 86(2):373–375, 2004; Mio et al., JBJS Case Connect 6(2):e241–e245, 2016; Patterson et al., Skeletal Radiol 43:1491–1494, 2014). The injury mechanism may include a planted foot, flexed knee, and eccentric contraction of the muscle, in a push off position. Patients often complain of pain with activity and movement. Radiographs are often obtained to evaluate for bony injury (Gottsegen et al., Radiographics 28(6):1755–1770, 2008). Management is usually nonoperative, and recovery occurs within 6–12 weeks (Patterson et al., Skeletal Radiol 43:1491–1494, 2014).