A 20-year-old white man presented with a localized unilateral swelling in the popliteal fossa. Ultrasound (US) showed the presence of an accessory muscle, the tensor fasciae suralis. The muscle was located in the proximal portion of the popliteal fossa, superficial to the medial head of the gastrocnemius. Its long tendon extended inferiorly to join the Achilles tendon. Magnetic resonance images correlated well with the US findings, confirming the diagnosis. Tensor fasciae suralis muscle is a rare cause of popliteal swelling and must be differentiated from other masses. Both US and magnetic resonance imaging can diagnose it but we suggest US as the first-line technique in its evaluation.
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