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Keywords:
Musculoskeletal system, Musculoskeletal soft tissue, Musculoskeletal joint, MR, Ultrasound, Elastography, Diagnostic procedure, Outcomes analysis, Physiological studies, Athletic injuries, Oedema, Trauma
Authors:
D. Orlandi1, A. Corazza2, E. Fabbro1, G. Ferrero1, L. M. Sconfienza3, E. Silvestri1; 1Genoa/IT, 2Genova/IT, 3San Donato Milanese/IT
DOI:
10.1594/ecr2014/C-0449
Conclusion
Combined d-HRUS-MR imaging allows to better evaluate thigh muscles providing a comprehensive anatomical representation of such structures and,
at the same time,
a detailed analysis of their internal architecture.
US is easily available,
is quick and has low costs,
allows a dynamic assessment of muscles and provides reliable assessment of the extent of damage.
Disadvantages of US are that its resolution is limited to the tertiary bundle and cannot visualise deep muscle planes as well as superficial ones.
It may provide negative results in lesions with only slight muscle alterations,
such as DOMS and grade 0-1 injuries.
Dynamic US evaluation adds to normal US-examination several important informations about biomechanics of muscular structures and helps to better determine the extention of a fibres tear and the stability of healing tissue.
MRI allows to recognize those lesions undetectable with US evaluation.
MRI has many advantages,
including multiplanar capabilities,
panoramic views,
ability to evaluate deep muscle planes and to detect lesions missed by US.
Combined d-HRUS and MR imaging allow to cover all diagnostic steps that follows through the athlete's injury and rehabilitation,
helping clinicians to more accurately estimate the time required before an athlete can return to competition as well as the related risk of recurrent injury.
Experience,
in combination with a deep knowledge of the anatomy,
will assist the musculoskeletal radiologist in making an accurate and useful contribution to the treatment of high-level professional soccer players.
Another important thing to remeber is that many of the injuries seen in professional soccer show no signs of fibre disruption even on MRI,
but still cause the majority of absence days.
Further,
it is very important to use high-quality imaging technology and to collaborate with the team medical staff in order to plan and guide athlete rehabilitation and have the shortest return-to-play time with the minimum risk for the athlete.
In our experience,
only a combination of high-level imaging and accurate clinical examination makes it possible to achieve correct management of injuried elite soccer players.