Skeletal Radiology

, Volume 46, Issue 3, pp 373–378 | Cite as

Semimembranosus muscle herniation: a rare case with emphasis on muscle biomechanics

  • Lena Naffaa
  • Hicham Moukaddam
  • Mohammad SamimEmail author
  • Aaron Lemieux
  • Edward Smitaman
Case Report


Muscle herniations are rare and most reported cases involve muscles of the lower leg. We use a case of muscle herniation involving the semimembranosus muscle, presenting as a painful mass in an adolescent male after an unspecified American football injury, to highlight a simple concept of muscle biomechanics as it pertains to muscle hernia(s): decreased traction upon muscle fibers can increase conspicuity of muscle herniation(s)—this allows a better understanding of the apt provocative maneuvers to employ, during dynamic ultrasound or magnetic resonance imaging, in order to maximize diagnostic yield and, thereby, limit patient morbidity related to any muscle herniation. Our patient subsequently underwent successful decompressive fasciotomy and has since returned to his normal daily activities.


Semimembranosus muscle Muscle Herniation Attachment and contraction center(s) Magnetic resonance imaging Ultrasound 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.




  1. 1.
    Richet. Traite d’anatomie chir. 1853; 124:(Cited by Choux).Google Scholar
  2. 2.
    De Maeseneer M, Shahabpour M, Lenchik L, Milants A, De Ridder F, De Mey J, et al. Distal insertions of the semimembranosus tendon: MR imaging with anatomic correlation. Skelet Radiol. 2014;43:781–91.CrossRefGoogle Scholar
  3. 3.
    Goldberg HC, Comstock GW. Herniation of muscles of the legs. War Med. 1944;5:365–7.Google Scholar
  4. 4.
    Ihde H. On muscular hernia of the leg. Acta Chir Scand. 1929;65:97–120.Google Scholar
  5. 5.
    Kitchin IDRDA. Multiple muscle herniae. BMJ. 1943;1:602–3.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    McMaster PE. Muscle hernia of the leg: a study of 21 cases and 38 hernias. US Nav Med Bull. 1943;41:404–9.Google Scholar
  7. 7.
    Mellado JM, Pérez del Palomar L. Muscle hernias of the lower leg: MRI findings. Skelet Radiol. 1999;28:465–9.CrossRefGoogle Scholar
  8. 8.
    Nguyen JT, Nguyen JL, Wheatley MJ, Nguyen TA. Muscle hernias of the leg: a case report and comprehensive review of the literature. Can J Plast Surg. 2013;21:243–7.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Schaefer WB. Nontraumatic tears of the tibial fascia. Mil Surg. 1943;93:308–10.Google Scholar
  10. 10.
    Sherry RH. Herniation of peroneus brevis muscle: report of a case. Bull Hosp Dis. 1942; 69–72.Google Scholar
  11. 11.
    Simon HE, Sacchet HA. Muscle hernias of the leg: review of literature and report of twelve cases. Am J Surg. 1945;67:87–97.CrossRefGoogle Scholar
  12. 12.
    Hesse Zur Frage der Radikaloperation der Hern en des Muscul tibialis anticus. (Russian orig) Ref Zentralorgan fur Chir. 1921; 271.Google Scholar
  13. 13.
    Harrington AC, Mellette JR. Hernias of the anterior tibialis muscle: case report and review of the literature. J Am Acad Dermatol. 1990;22:123–4.CrossRefPubMedGoogle Scholar
  14. 14.
    Marques A, Brenda E, Amarante MT. Bilateral multiple muscle hernias of the leg repaired with Marlex mesh. Br J Plast Surg. 1994;47:444–6.CrossRefPubMedGoogle Scholar
  15. 15.
    Zeiss J, Ebraheim NA, Woldenberg LS. Magnetic resonance imaging in the diagnosis of anterior tibialis muscle herniation. Clin Orthop Relat Res. 1989; 249–53.Google Scholar
  16. 16.
    Koulouris G, Connell D. Hamstring muscle complex: an imaging review. Radiographics. 2005;25:571–86.CrossRefPubMedGoogle Scholar
  17. 17.
    De Smet AA. Magnetic resonance findings in skeletal muscle tears. Skelet Radiol. 1993;22:479–84.CrossRefGoogle Scholar
  18. 18.
    De Smet AA, Fisher DR, Heiner JP, Keene JS. Magnetic resonance imaging of muscle tears. Skelet Radiol. 1990;19:283–6.CrossRefGoogle Scholar
  19. 19.
    Govindarajan A, Inigo A. Tibialis anterior muscle hernia: a rare differential of a soft tissue tumour. BMJ Case Rep. 2015; 2015.Google Scholar
  20. 20.
    Yochim SE, Jose J, Clifford PD. Muscle herniation of the extremity. Am J Orthop (Belle Mead NJ). 2010;39:95–6.Google Scholar
  21. 21.
    Lee H-S, James M. Painful bilateral herniation of the anterior tibial muscle: a case report. Foot Ankle Int. 2006;27:552–5.CrossRefPubMedGoogle Scholar
  22. 22.
    Miniaci A, Rorabeck CH. Compartment syndrome as a complication of repair of a hernia of the tibialis anterior: a case report. J Bone Joint Surg Am. 1986;68:1444–5.CrossRefPubMedGoogle Scholar
  23. 23.
    Dawar AK, Dawar R, Gawri KGV. Tibialis anterior muscle hernia: a rare cause of leg pain. JCR. 2012;2:42–4.CrossRefGoogle Scholar
  24. 24.
    Henning PT, Dahm DL, Smith J. Use of postexercise ultrasonography to identify a symptomatic extensor digitorum longus muscle hernia associated with running. PM R. 2009;1:1109–11.CrossRefPubMedGoogle Scholar

Copyright information

© ISS 2016

Authors and Affiliations

  • Lena Naffaa
    • 1
  • Hicham Moukaddam
    • 2
  • Mohammad Samim
    • 3
    Email author
  • Aaron Lemieux
    • 4
  • Edward Smitaman
    • 5
  1. 1.Department of Diagnostic RadiologyAmerican University of BeirutRiad El-SolhLebanon
  2. 2.Saint Rita Medical CenterLimaUSA
  3. 3.Department of Radiology, Hospital for Joint DiseaseNew York UniversityNew YorkUSA
  4. 4.San Diego School of MedicineUniversity of CaliforniaLa JollaUSA
  5. 5.Teleradiology & Education CenterUniversity of California, San DiegoSan DiegoUSA

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