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Age / Sex : /
Age/Sex : 61/F
C.C.: Palpable mass in left shin, trauma history(-)
1) What is your impression?
Courtesy : Sang Hoon Lee, MD Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine
Diagnosis: hernia of tibialis anterior muscle
Discussion
Findings:
- defect of muscle fascia
- Anterior bulging and herniation of tibialis anterior muscle
Diagnosis: Hernia of tibialis anterior muscle
Discussion:
- A muscle hernia is a focal protrusion of muscle tissue through a defect in the deep fascial layer.
- Common disorder in the leg, especially involving the middle and lower thirds.
- The tibialis anterior hernia is the most frequent, although involvement of the extensor digitorum longus, peroneus brevis, and gastrocnemius have also been reported.
- Usually present in athletes, soldiers, and in professions requiring great strain on the legs.
- Usually asymptomatic subcutaneous nodule or mass that vary in size depending on position. - Traumatic: direct (fascial injury) and indirect (injury to contracted muscle) types.
- Constitutional: may be due to a congenital defect in the fascia.
- MRI, CT, and ultrasonography have been used to identify the fascial defect.
- Treatment: longitudinal fasciotomy
References:
1) JM Mellado, LP Palomar. Muscle hernias of the lower leg: MRI findings. Skeletal Radiol (1999) 28:465-469
2) JE Lane, CM Woody, JL Lesher. Tibialis Anterior muscle herniation. Dermatol Surg 28:7:July 2002
3) JC Lee, Jeremiah Healy. Sonography of lower limb muscle injury. AJR (2004) 182:341-351 4) Anil Agarwal, Rachna Agarwal. Abnormal presentation of tibialis anterior herniation. Eur J Orthop Surg Tarumatol (2006) 16:271-272
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