In retrospect, the left superior lumbar hernia was also present on a prior MRI of the lumbar spine, although incompletely imaged at the edge of the field of view on that study. The MRI is from 2 years prior to the ultrasound. The hernia is located posterior to the lower pole of the left kidney. Medial to the hernia is the quadratus lumborum muscle, superior to the hernia is the 12th rib, and superficial to the hernia is the latissimus dorsi muscle.