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Image challenge
Recurrent calf pain after sport activity
  1. Antonio J Martín-Jiménez1,
  2. Francisco Miralles-Aguiar2,
  3. Daniel García-Gil3
  1. 1 Unidad de Gestión Clínica de Urgencias, Hospital San Carlos, San Fernando, Spain
  2. 2 Unidad de Gestión Clínica de Anestesiología y Reanimación, Hospital Universitario Puerta del Mar, Cadiz, Spain
  3. 3 Unidad de Ecografía Clínica. Servicio de Medicina Interna, Hospital San Carlos, San Fernando, Spain
  1. Correspondence to Dr Antonio J Martín-Jiménez, Unidad de Gestión Clínica de Urgencias, Hospital San Carlos, San Fernando 11100, Spain; antoniomartinjimenez{at}hotmail.es

https://doi.org/10.1136/emermed-2023-213638

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    Clinical introduction

    A previously healthy 46-year-old man experienced acute mid-calf pain while playing paddle tennis. He treated himself with non-steroidal anti-inflammatory drugs and local cold application, and took a rest. One week later, he consulted the ED due to persistent pain and swelling in the area. Examination revealed tenderness to palpation of the medial belly of the gastrocnemius muscle. A point-of-care ultrasound was performed (figure 1).

    Figure 1

    Ultrasound image longitudinal section of the calf region.

    Question

    What is the most likely diagnosis?

    1. Morel-Lavallée lesion

    2. Pyomyositis

    3. Complicated Baker’s cyst

    4. ‘Tennis leg’ injury

    Answer: D

    Rupture of the medial portion of the medial gastrocnemius muscle, commonly known as ‘tennis leg’, often occurs during sports such …

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    Footnotes

    • Contributors DG-G planned the study. FM-A did the clinical history, treated the patient and collected the images. DG-G critically revised the manuscript and reviewed the bibliography. AJM-J wrote the manuscript and submitted it.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.