Le muscle soléaire accessoire: à propos de deux cas avec revue de la littérature

The purpose of this study is to present two cases of accessory soleus muscle diagnosed in young athletes. The authors give diagnostic and therapeutic recommendations with a literature review. Two young athletes consulted us for leg pain increasing with athletic activity. Physical examination revealed a soft, non-tender mass medial to Achilles' tendon. Lateral X-ray view of both ankles revealed an obliteration of Kager's fat pad. Computed tomography (CT) and magnetic resonance imaging (MRI) showed muscular masses of the posterior compartment of the leg. The accessory soleus was excised from its origin to its distal insertion. The postoperative outcome was good and the previous sporty activity was regained within few months. The accessory soleus muscle is a rare supernumerary muscle of the leg whose clinical manifestation is exceptional. Different anatomic types have been described. Clinical presentation consists most often in a mass of the postero-medial compartment of the leg, which becomes painful during the effort. MRI is the major diagnostic tool. It not only allows diagnostic confirmation but also guides the treatment. As far as therapy is concerned, surgery is not the only alternative, but it remains the most efficient one. Conclusion: The accessory soleus is not so rare. Recognizing this anomaly using clinical findings, X-rays and MRI investigation results in proposing a management adapted to the importance of the functional discomfort. Surgery remains the most efficient treatment.