PMC4875971_01
Isolated injury of the Crural Fascia, with considerable thickening of same (asterisk). Note the structural integrity of the medial gastrocnemius (MG) epimysium and of the soleus (SL), indicated by the arrows, and the absence of intramuscular edema. The muscle belly of the MG and Lateral Gastrocnemius (LG) are observable, a sign that the injury is not at muscle-tendon junction level.
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fig2
However, a considerable enlargement of the connective component interposed between the muscles was observed, compatible with structural injury and retractions of the CF (Figure 2).
Interfascial blood (asterisk), observed at the distal region of the injury.
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fig3
The framework was aggravated by the presence of an extended interfascial spillage, probably blood (Figure 3).
MRI axial section, performed two months after the injury. The arrow shows the thickening scar of the right Crural Fascia. Within the scar tissue, intrascar liquid residue, visible as a black dot, is detectable.
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fig4
Despite physiotherapy proposals, the healing process was completed by the formation of a hypertrophic reparative scar tissue; the presence of intrascar liquid still remained modest (Figure 4).
High resolution cross-sectional ultrasound of the Achilles tendon suffering from acute paratendinopathy. Laterally to the body of the Achilles tendon (filled arrow), a hypoechoic area is visible (dotted arrow), which is compatible with fluid collection between the tendon and the paratenon.
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fig5
The picture was confirmed through ultrasound examination (Figure 5).