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61/F Palpable mass in left shin, trauma history(-)

61/F Palpable mass in left shin, trauma history(-). 61/F Palpable mass in left shin, trauma history(-). T1WI. T2WI. Gd-enhaned T1WI. T2WI. Answer. Hernia of tibialis anterior muscle. Findings. defect of muscle fascia Anterior bulging and herniation of tibialis anterior muscle.

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61/F Palpable mass in left shin, trauma history(-)

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  1. 61/F Palpable mass in left shin, trauma history(-)

  2. 61/F Palpable mass in left shin, trauma history(-) T1WI T2WI Gd-enhaned T1WI T2WI

  3. Answer • Hernia of tibialis anterior muscle

  4. Findings • defect of muscle fascia • Anterior bulging and herniation of tibialis anterior muscle

  5. 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.

  6. Discussion • 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

  7. References • JM Mellado, LP Palomar. Muscle hernias of the lower leg: MRI findings. Skeletal Radiol (1999) 28:465-469 • JE Lane, CM Woody, JL Lesher. Tibialis Anterior muscle herniation. Dermatol Surg 28:7:July 2002 • JC Lee, Jeremiah Healy. Sonography of lower limb muscle injury. AJR (2004) 182:341-351 • Anil Agarwal, Rachna Agarwal. Abnormal presentation of tibialis anterior herniation. Eur J Orthop Surg Tarumatol (2006) 16:271-272

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