Venolymphatic malformation of the proximal gastrocnemius muscle in a girl.

The patient was an 8-year-old girl who was referred to a physical therapist by her pediatrician for a chief complaint of worsening proximal right calf pain and progressive right-sided toe walking for the past 6 weeks. Due to concern that the patient's symptoms were nonmusculoskeletal in nature, the physical therapist discussed the history and physical examination findings with the patient's pediatrician and an orthopaedic surgeon. Subsequent magnetic resonance imaging and percutaneous biopsy led to a diagnosis of a low-flow venolymphatic malformation of the proximal gastrocnemius muscle.