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Journal of the Korean Academy of Rehabilitation Medicine 1999;23(3):664-669.
Soleus Myopathy Induced by Passive Stretch in a Stroke Patient: A case report.
Kim, Young Jun , Park, Insun , Lee, Young Joon , Kim, Chan Hwan , Choi, Jang Seok , Jo, Geun Yeol
1Department of Rehabilitation Medicine, Inje University College of Medicine.
2Department of Diagnostic Radiology, Inje University College of Medicine.
3Department of Pathology, Inje University College of Medicine.
4Department of Orthopedic Surgery, Inje University College of Medicine.
5Department of Physical Medicine & Rehabilitation, Sung Kyun Kwan University College of Medicine.
뇌졸중 환자에서 수동적 신장에 의해 발생된 가자미근의 근병증 ⁣증례 보고⁣
김영준, 박인선, 이영준1, 김찬환2, 최장석3, 조근열4
인제대학교 의과대학 재활의학교실, 1진단방사선과학교실, 2해부병리과학교실, 3정형외과학교실, 4성균관대학교 의과대학 재활의학교실
Abstract

We present a 50-year-old woman who sustained spastic left hemiplegia secondary to the right thalamic hemorrhage 6 years ago. She complained of persistent severe left calf pain after serial casting for the treatment of shortened plantar flexors of the left ankle. Two months later, magnetic resonance T1-weighted images showed diffuse high signal intensity involving the whole muscle bulk of the soleus and normal signal intensity of thin atrophied gastrocnemius. Needle electromyography of the soleus revealed myopathic patterns. Histologic findings of the soleus showed necrotic muscle fibers with phagocytosis, endomyseal collagen and fat deposition. We concluded that prolonged passive stretch of spastic plantar flexors of the ankle under serial casting induced soleus myopathy with segmental myonecrosis, and which developed left calf pain. Selective induction of soleus myopathy could be explained by the higher stretch tension produced by ankle dorsiflexion in the soleus compared to the gastrocnemius because of different proximal ends.

Key Words: Soleus, Myopathy, Serial casting, Passive stretch


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