Presentation
Left leg painless anterior rounded swelling that appears on standing.
Patient Data
Focal outline bulge of the skin shadow at the middle of the leg.
Focal muscle fascial defect is noted anteriorly at the tibialis anterior muscle at the mid-leg level just lateral to the chin of tibia. The defect measures 8 x 10 mm with herniation of muscle on standing position. The herniated part of the muscle appears hypoechoic than rest of the muscle lying deep to the fascia.
Case Discussion
The patient had a history of left leg anterior traumatic wound by an iron rod since 5 years. Ultrasound shows a focal fascial defect with muscle herniation involving the middle of tibialis anterior muscle on standing position, in keeping with fascial tear with muscle hernia.
On ultrasound examination for suspected muscle hernias, it is recommended to put muscle in action, use a lot of jel and avoid pressure so as not to reduce the hernia.