Translevator perineal hernia; an incidental rare imaging presentation

Translevator perineal hernias are rare pelvic floor defects that can be classified based on their anatomical location as either anterior or posterior relative to the transverse perineal muscle. This report describes an unusual clinical and radiological presentation of a posterior perineal hernia in an elderly lady. The case highlights the limitations of CT when findings are not definitive and the role of MRI as a superior problem-solving tool to better delineate the pelvic anatomy, exclude sinister pathology and confirm the diagnosis.