Transfascial Muscular Hernias

摘要

A 28-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 [ ]. The lesions were asymptomatic but became painful after hours of standing or during physical exercise. The 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 findings. 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 findings [ ]. The 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 [ ]. These findings were evident due to the increase in muscle pressure while standing. Furthermore, in the Doppler mode, blood vessels going through the muscle at the sites of muscular protrusions were observed [ ]. The 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.