Case of the Week — November Case # 2

36 y/o male presents to ED with c/o pain to back of right lower leg. Pain began the day prior while playing basketball. Pain was sudden onset while running and pt now unable to plantar flex his foot. PMHx: none PE: BP 98/60, P83, R16, T98.6, POx 92% RA EXT: no discoloration or bruising, mild edema to R calf w/ TTP, decreased ROM R foot - unable to plantar flex, sensation intact, 2+ distal pulses bilaterally. Thompson test positive. What is your differential diagnosis? Bedside ultrasound is used to evaluate the injury - what does the image indicate? Special thanks to Ashley Doscher and Matt Hale who submitted this image!