Gastrocnemius Muscle Tear (Calf Tear)

The patient was a 46 year old man, referred from his neighborhood GP.

The story was that he was helping a friend push a stalled car. While doing so, he heard a “snapping” sound from the back of his right leg. This was accompanied by pain; however he still managed to limp back. Back home, he applied some ice onto the leg (good for him), the swelling and bruising didn’t appear until the next morning.

He related the story to me on the initial visit, nine days after the injury. Why nine days? Well apparently I was the fourth medical professional he has sought, the 3rd one being the GP who finally referred him here.

Listening to his story carefully, my initial suspicion was that he may have torn his achilles tendon. However a complete tear would render him almost incapable to walk; he was limping to my clinic, sure, but not to the extent that he had to be wheeled into the room.

Examination of his leg showed some swelling of his lower leg, with bruising around the ankle and foot. Tenderness could be felt around the calf muscles. There was no palpable defect on his achilles tendon indicating a torn tendon nor was Simmons test positive for achilles cut.

So that rules out an achilles tendon injury.

Hmmm…

An ultrasound or MRI scan would help in this matter. I promptly sent him across the hallway to see the radiologist requesting for an ultrasound of his calf muscle, failing which we may proceed on to do a MRI scan.