Learning objectives
The purpose of our educational exhibit is to highlight the occurrence of fat herniation and its radiological presentation.
Background
Hernia intermuscular adipose tissue of the lower extremities is a rare condition that occurs through weak points of fascia cruris ( a fascia of the leg that forms a complete investment to the muscles) crossed by perforating vessels that cause fascial defect,
most between tibialis anterior and extensor muscles,
simulating muscle herniation.
We present a case of a 15-years old woman presented to our observation with a history of pain and weakness of the legs.
She was referred to our department because of onset of...
Findings and procedure details
Our young patient was underwent to a dynamic ultrasonographic study,
performing an axial and longitudinal scan of the mass with a 18 MHz linear transducer (MyLab TWICE,
Esaote Biomedica,
Genoa,
Italy) ,
with the patient in upright position and tibialis anterior muscle tension,
that showed small hypoechoic formations through fascia cruris defect crossed by perforating vessels (fig.
1-3) ,
to report to small hernias intermuscular adipose tissue,
condition that occurred when some position of the leg increase the pressure inside.
Subsequently,
she performed a MRI...
Conclusion
The diagnosis of fat herniation should be considered in patients with positionally variable subcutaneous nodules,
especially in the lower extremities,
a rare condition occurred through weak points of fascia cruris crossed by perforating vessels that cause fascial defect.
Ultrasonographic examination is useful for detecting the fascial defect; in addition to offering high-resolution imaging,
ultrasound also provides the capability of real-time dynamic assessment of soft-tissue structures excluding other conditions caused by soft tissue tumours such as lipomas,
angiolipomas,
fibromas and the relatively common condition of muscle...
References
[1] Troy Henning P,
Dahm DL,
MD,
Smith J.
Use of Postexercise Ultrasonography to Identify a Symptomatic Extensor Digitorum Longus Muscle
Hernia Associated with Running; American Academy of Physical Medicine and Rehabilitation
Vol.
1,
1109-1111,
December 2009
[2] Jarrett D,
Kramer DE, Callahan MJ,
Kleinman PK.
US diagnosis of pediatric muscle hernias
of the lower extremities.
Pediatr Radiol (2013) 43 (Suppl 1):S2–S7
[3] Ali Murat Ceyhan,Wenchieh Chen,Mahmut Yener et al.
Bilateral tibialis anterior muscle herniation simulating a
soft tissue tumour in a young amateur football...