Imaging in the diagnosis of symptomatic forearm muscle herniation

Abstract

Muscle herniation can be defined as protrusion of a portion of muscle through an acquired or congenital defect of enclosing fascia. Although it is usually a cosmetic problem, it can lead to local pain and tenderness after prolonged exertion. In this report, we present a case of flexor digitorum superficialis muscle herniation in a 58-year-old man. The radiographic, ultrasonographic and magnetic resonance imaging findings are described with dynamic examination, permitting demonstration of muscle herniation through the fascial defect during muscle contraction.

Soleus Muscle Herniation With Magnetic Resonance Imaging and Ultrasound Correlation in a Female Long‐Distance Runner: A Case Report

“…Our case presents a constitutional (congenital) muscle herniation as a result of a fascial defect that was precipitated by increased training intensity in a long‐distance runner in whom no trauma was sustained. Muscle herniations of the limbs most commonly occur in the lower limb involving the tibialis anterior [3‐5]. A clinical differential diagnosis for a posterior (superficial and deep) compartment exertional mid‐muscle pain includes a gastrocnemius and/or soleus strain or tear, chronic exertional compartment syndrome, varicosities, arteriovenous malformations, angiomas, soft‐tissue tumors, and muscle herniations [10].…”

“…It is an injury that originally was described in athletic men or individuals with occupations requiring excessive strain on the legs, most notably military recruits [1‐3]. More than 200 case reports in the literature since the original accounts reveal that there is a greater incidence of muscle herniation in men compared with women [3‐5]; however, the exact incidence and prevalence is unknown, partly because of the fact that muscle herniations can be asymptomatic [6]. Current management is variable, ranging from conservative treatment such as activity modification and physical therapy to surgical intervention [3,4,7‐9].…”

Gastrocnemius muscle herniation as a rare differential diagnosis of ankle sprain: case report and review of the literature

“…However, as seen in our case, a fascial thinning is sometimes difficult to detect. It has been suggested the use of dynamic MR imaging in the evaluation of suspected muscle herniations to better delineate the fascial defect and the size of the muscle herniation, if dynamic sonography does not adequately define these features [26,27]. It was hypothesized that MRI can be useful in planning operative treatment [28].…”

Treatment of a Symptomatic Forearm Muscle Herniation With a Mesh Graft

“…5,8,16 Dynamic MRI before and after muscle contraction can delineate the fascial defect and size of muscle herniation. 5 …”