To learn more about How to examine muscle injuries with MRI (coil, sequences). MRI pattern of direct and indirect muscle injuries illustrated by clinical cases. Different classification systems and their prognostic value in predicting time to return to full training. Potential future MR-sequences in clinical muscle imaging.

Especially in competitive sports, muscle injuries constitute about 30% of all sports-related injuries with an average lay-off time of 14 days.Hamstring injuries are one of the most affected muscle groups (37% of muscle injuries in professional football players). Nearly all muscle injuries can be treated conservatively but not all clinically detected muscle injuries can be visualized by standard MR-sequences. Nonetheless MRI is the reference standard in diagnosing and classifying muscle injuries and helps to prognosticate time to return to full training.

Muscle oedema, architectural distortion / rupture of muscle fibres and intra- or intermuscular haemorrhage are relevant changes in muscles that can visualized with high resolution MRI. A flexible body coil allows to reach a homogenous MR signal. In some cases it could be helpful to mark the painful area with a capsule. Proposed MRI protocol: Coronal Short-Tau Inversion Recovery (STIR), slice thickness: 4 mm Axial Proton density fat saturated (PD fs), thickness: 3 mm Sagittal Proton density fat saturated (PD fs),slice thickness: 3 mm Coronal...

MRI plays a crucial role in managing muscle injuries in competitive sports. On the one hand MRI has the potential to estimate lay-off time and to identify injuries that will cause longer lay-off times by using classification systems.The Munich Muscle Injury Classification is based on clinical examination combined with MRI whereas the very detailed British Athletics Muscle Injury Classification allows a precise graduation of muscle injuries with the use of high resolution MRI. Furtherstudies arenecessary in order to validate these classification systems regarding lay-off time....

Ekstrand J, Askling C, Magnusson H, Mithoefer K. Return to play after thigh muscle injury in elite football players: implementation and validation of the Munich muscle injury classification. Br J Sports Med 2013;47:769-774. Ekstrand J, Hägglund M, Waldén M. Epidemiology of Muscle Injuries in Professional Football (Soccer). Am J Sports Med 2011 39: 1226. FroelingM,Oudeman J,Strijkers GJ,Maas M,Drost MR,Nicolay K,Nederveen AJ.Musclechangesdetected with diffusion-tensor imaging after long-distance running.Radiology.2015 Feb;274(2):548-62. Mueller-Wohlfahrt HW, Haensel L, Mithoefer K, Ekstrand J, English B et al. Terminology and classification of muscle...

Dr. Florian Jungmann Diagnostic and Interventional Radiology, University Medical Center Mainz [email protected]