Unilateral toe-walking secondary to intramuscular hemangioma in the gastrocnemius

Unilateral toe-walking secondary to intramuscular hemangioma in the gastrocnemius

Fujio Umehara, Eiji Matsuura, Shinichi Kitajima, Mitsuhiro Osame

An 11-year-old girl presented with a 1-year history of increasing right calf pain and progressive right-side toe-walking. Physical examination revealed toe-walking in the right leg (video) and tenderness in the right calf. MRI and an open diagnostic biopsy led to the diagnosis of IM hemangioma (figure 1). Two reports contributed six cases of toe-walking caused by hemangioma of the calf musculature.1,2 IM hemangioma is rare, comprising only 0.8% of all venous malformations. When the hemangioma involves the flexor muscles of the leg, equinus deformity and toe-walking may result. The patient had a percutaneous sclerotherapy that provided slight relief of pain.