Tibialis Hernias

A muscle hernia is a protrusion of muscle through a defect in the epimysium. There is often a previous history of trauma or surgery. Patients present with a palpable lump that may become more apparent and/or painful on standing or exercise. The commonest affected site is the lower leg, particularly the tibialis anterior muscle which has an intrinsic weakness in its overlying fascia due to penetrating... 

Fig. 4.23. Ultrasound demonstrating a small muscle hernia of the tibialis anterior on contraction, with a focal bulge in the normal contour arrowheads)...

Muscle hernias are focal protrusions of muscle tissue through fascial defects. In the lower leg, herniation of muscle is most commonly observed in the middle and lower thirds affecting the tibialis anterior muscle, although involvement of the extensor digitorum longus, peroneal muscles and the lateral head of the gastrocnemius have also been reported (Mellado and Perez del Palomar 1999). The area overlying the anterior intermuscular septum. 

Fig. 15.15a-c. Muscle hernia, a-c Transverse 12-5 MHz US images obtained with different degrees of probe pressure over the defect show disruption of the tibialis anterior muscle fascia (open arrowhead) from the tibia (T) and subsequent muscle herniation within the subcutaneous tissue asterisks). Note progressive reduction of the herniation with graded compression. White arrowhead indicates the internal aponeurosis of the tibialis anterior muscle... 

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