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Caudal Rectus Abdominis - for Dr. Wascher

Dr. Wascher,

Since you have been helpful in explaining things to many posters here, I am hoping you can help me. I am NOT looking for a diagnosis just input and some information, since you are a surgeon.

First, since it will be hard for you to explain in words, so can you provide a link (private message me if you'd like) that shows pictorially where the caudal rectus abdominis tendon is located (perhaps a Grey's anatomy picture or an MRI scan found online)

I had an MRI done for a sports hernia that claims "abnormal morphology of the caudal rectus abdominis tendon compatible with a lateral edge tear and/or detachment"

Now, my questions... (a quick yes or no is fine)

1.) Would this lateral edge tear be visible to a surgeon who is repairing a deficiency of the posterior inguinal wall?

2.) Could this defect lead to or cause atrophy of the rectus abdominis on one side in an MRI?

3.) Could this defect give a 'balling up' sensation of a lump or knot when raising one's leg while standing, like to tie a shoe?

I know these are very specific, but thank you for helping with these questions.
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replied January 23rd, 2010
I am unable to provide you with a link to an online anatomy page, but most public libraries have one or more anatomy atlases available. The "caudal rectus abdominis tendon" refers to the site on the upper pubic bone where the rectus muscle attaches to this bone. (The rectus abdominis muscles are the two vertical strap-like muscles that give your abdomen that "six-pack" appearance.)

In answer to your questions: (1) If the tear is nearly complete, or complete, then it will likely be visible to the surgeon in the OR (if surgery becomes necessary). (2) If the muscle was denervated by the injury, or if you stopped using the muscle (i.e., due to pain) for a long time, then atrophy might also occur. (3) If the muscle is truly detached from the upper pubic ramus, then any activity that causes the rectus muscle to contract could result in the detached portion of the muscle "balling up."

Sincerely/ Robert A. Wascher, MD, FACS

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