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Keywords:
Musculoskeletal soft tissue, Musculoskeletal system, Ultrasound, MR, Diagnostic procedure, Athletic injuries, Trauma
Authors:
D. Capannelli, M. Miceli, M. Piolanti, F. Monetti, S. Galletti, L. Barozzi; Bologna/IT
DOI:
10.1594/ecr2014/C-0822
Aims and objectives
The objective of this study was to evaluate the role of ultrasonography (US),
compared with magnetic resonance imaging (MRI),
in the diagnosis and follow up of traumatic muscle injuries.
Muscle injury is one of the most common event occurring in sport traumatology and require careful clinical and instrumental evaluation and timely treatment in order to restore a good functional outcome.
Particularly in elite athletes,
where decisions regarding return to play and player availability have significant financial or strategic consequences for the player and the team,
there is an enormous interest in optimizing the diagnostic procedures.
Ultrasound (US) and magnetic resonance imaging (MRI) are the most useful imaging techniques to assess the presence and degree of muscle injuries.
The recent advances in US technology producing detailed images allow diagnosis with similar accuracy as MR imaging.
An early post-injury US,
performed between 6 and 72 hours after trauma,
provides helpful informations about any existing disturbance of the muscle structure,
particularly if there is a hematoma.
US also allows real-time functional and dynamic assessment of muscles and tendons,
combines this information with physiological assessment of blood flow in Doppler imaging,
is well tolerated,
noninvasive and cost-effective.
Muscle injuries are classified according to the mechanism of injury into direct or indirect trauma.
- Direct injuries,
such as lacerations or contusions,
are caused by external forces that cause a blunt trauma of the muscular tissue with associated hematoma at the injured site.
The most frequently involved muscles in athletes are the exposed rectus femoris and the intermediate vastus,
lying next to the bone with limited space for movement.
- Indirect injuries,
such asDelayed Onset Muscle Soreness(DOMS),
lengthenings and strains,
are caused by a sudden forced lengthening over the viscoelastic limits of muscles and occurring during a powerful contraction (internal force).
The typical site of injury is the muscle–tendon junction,
a biomechanical weak point.
The quadriceps muscle and the hamstrings are frequently affected since they have large intramuscular or central tendons and can be injured along this interface.
Certain muscle groups are predisposed to injury depending on the type of sport: in soccer and basketball players lower limb are often involved (hamstrings,
adductors,
quadriceps and calf muscles) and injuries typically occur in non-contact situations.