Imaging in the Diagnosis of Symptomatic Forearm Muscle Herniation.
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Date
2013-05
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Abstract
Symptomatic muscle herniations are an unusual cause
of upper extremity pain that is rarely reported in the literature.
Out of 18 reported cases of upper extremity herniations,
only 3 were caused by strenuous exertion6. Dynamic
ultrasound and Dynamic MRI test are the very good tool
for diagnosis of muscle herniation, FNAC and biopsy are
rarely needed. This article describes a successful repair of
a 22yr old manual worker’s ventral forearm herniation with
polypropylene mesh.
Prevalence
Muscle herniation in an extremity is a well-known cause
of pain, even though there have been extremely few
documented cases. In a 2009 report published by the
“Journal of Hand and Microsurgery,” only 200 cases of
herniated muscles of the extremities had been reported since
the mid-1800s, and only 17 cases of muscle herniation in
the upper limb have been described10.
Characteristics
A herniated muscle in the forearm can cause mild to
severe localized pain, affect grip, cause nerve pain or have
no physical symptoms at all. Causes of documented cases
include sporting or occupational activities, or an unrelated
primary medical condition. Patients usually have a swollen
mass that increases in size when the affected muscle is
engaged and decreases when the muscles are relaxed. One
differential diagnosis for a herniated forearm muscle is a
tumor. Muscle herniation in the forearm typically affects
males in their adolescent or young-adult years1.
We report a case of a disappearing forearm nodule that
appeared with muscle contraction. This is characteristic
of a transfascial muscle hernia. Ultrasound and MRI are
the key to identifying an area of fascial alteration. Treatment
alternatives of this unusual condition are discussed.
Description
Keywords
dynamic MRI, flexor carpi radialis, muscle herniation, mesh graft
Citation
Khajotia B L,Tomar R P S, Meena L. Imaging in the Diagnosis of Symptomatic Forearm Muscle Herniation. Indian Medical Gazette. 2013 May ; 147 (5): 199-202.