HSS Ultrasound Case 68

Clinical History 35 year old male with painful swelling over the anterior shin during exercise, noticed several months prior.

An ultrasound was requested to assess for an underlying soft tissue mass.

Ultrasound of the Month – Case 68

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Ultrasound of the Month – Case 68

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Diagnosis Muscle herniation of the anterior tibialis muscle

Discussion Focal herniation of muscle through a defect of the fascia can be symptomatic, causing either a palpable lump beneath the skin or vague compartment syndrome-like pain.

Onset of symptoms upon exercise is classic.

Ultrasound allows direct visualization of the herniating muscle, which can usually be elicited upon active muscle contraction by the patient.

Because of this dynamic component to the evaluation, ultrasound is the best modality for diagnosing this entity; MRI, because it is a static exam, may not be able to identify the herniating muscle.

Ultrasound of the Month – Case 68

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