Transfascial Muscular Hernias: Diagnosis by dynamic ultrasonography
Journal Title: Sultan Qaboos University Medical Journal - Year 2019, Vol 19, Issue 3
Abstract
A28-year-old male patient presented to the Department of Dermatology of the Hospital Clínic de Barcelona, Barcelona, Spain, in 2018 with a seven-year history of skin-coloured soft nodules on the anterior and lateral sides of the legs that appeared when standing and disappeared with pressure release [Figure 1]. Te lesions were asymptomatic but became painful after hours of standing or during physical exercise. Te patient had performed weightlifting in the past and denied any previous trauma in the areas where the nodules appeared. A skin biopsy and a musculoskeletal magnetic resonance imaging (MRI) scan, performed at another institution, reported no pathological fndings. An ultrasonographic examination with an 18-MHz probe (MyLab™ Class C, Esaote, Genoa, Italy) of the lateral side of the left leg at rest was performed with no pathological fndings [Figure 2A]. Te examination was repeated with the patient in a standing position, revealing thinning and partial discontinuity of the fascial layer resulting in muscular protrusion to the subcutaneous tissue [Figure 2B]. Tese fndings were evident due to the increase in muscle pressure while standing. Furthermore, in the Doppler mode, blood vessels going through the muscle fascia at the sites of muscular protrusions were observed [Figure 2C]. Te patient was diagnosed with transfascial muscular hernias of the lower extremities. He was conservatively managed and the lesions had not progressed at the one-year follow-up.
Authors and Affiliations
Xavier Fustà-Novell, Daniel Morgado-Carrasco, Pilar Iranzo, Priscila Giavedoni
Keywords
Related Articles
- EP ID EP168134
- DOI http://dx.doi.org/10.18295/squmj.2019.19.03.016
- Views 283
- Downloads 0
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