Conservative Management of Tibialis Anterior Muscle Herniation Prior to Surgical Intervention: A Case Report.

Muscle herniation is a rare condition characterized by protrusion of muscle tissue through a fascial defect, most commonly involving the tibialis anterior muscle. We report the case of a 55-year-old man presenting with a painful intermittent swelling on the anterolateral aspect of the right leg that became more prominent during standing and physical activity following a remote history of trauma. Physical examination revealed a soft, tender mass over the middle third of the leg without neurological deficits. Dynamic ultrasonography demonstrated a fascial defect with protrusion of the tibialis anterior muscle, confirming the diagnosis of tibialis anterior muscle herniation. The patient was managed conservatively with rest and compression bandaging, resulting in significant pain relief and partial reduction in hernia size after a three-month follow-up. This case highlights the importance of considering muscle herniation in the differential diagnosis of chronic leg pain and intermittent soft tissue swelling. Dynamic ultrasonography remains a valuable diagnostic tool, and conservative treatment may provide satisfactory outcomes in selected symptomatic patients.