How to Locate the Plantaris Tendon of the Calf on Your MSK Ultrasound Exam

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How to Locate the Plantaris Tendon of the Calf on Your MSK Ultrasound Exam

By Learn MSK Sono FEATURING Jamie Bie, RMSKS, RVT, RDMS

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May 26, 2023

In addition to the gastrocnemius-soleus complex, which structure should also be evaluated when you get ...
read more ↘ a referral to rule out a calf tear?

The plantaris tendon. This long, thin tendon originates above the knee joint at the lateral femoral condyle and courses medially in the calf before inserting onto the posteromedial aspect of the calcaneus, either medial or anterior to the Achilles tendon.

You can locate this tendon on ultrasound by placing the transducer over the medial aspect of the mid to distal posterior calf to visualize the tiny plantaris tendon where it lies between the medial head of the gastrocnemius muscle and the soleus muscle.

It is important to routinely include this tendon in your protocol so that you do not confuse a plantaris tear for a medial gastroc tear. If you know where to look for the plantaris tendon on your exam, then you will be able to easily differentiate them.

When a fluid collection is present in the expected location of the plantaris tendon without visualization of the tendon, then a plantaris tear should be suspected. A medial gastroc tear usually occurs further distal in the calf at the level of the myotendinous junction, but may extend proximally. It is possible for them to coexist.
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