Learning objectives
- Highlight the role of ultrasound in the diagnosis of lower limb injuries of the muscle in athletes;
- Illustrate and classify several muscular lesions.
Background
MUSCLE INJURIES
Muscle injuries are inevitable complications of physical activity,
particularly in elite athletes submitted to high loads of forces during their activity.
They have an important physical and economic impact for the athlete,
but also affect the coach,
the entire team and the fans.
Imaging techniques assume a pivotal role in helping the clinician diagnose or confirm the injury,
determine its extent and severity.
Therefore,
they are an important tool for the physician to establish the best time to come back to training and...
Findings and procedure details
NORMAL MUSCLE
Muscle fibers are hypoechoic structures arranged in a parallel fashion and surrounded by hyperechoic fibroadipose septa called perimysium.
The epimysium is an hyperechoic fibrous fascia that envelops the entire muscle.
Fascia and tendons also appear hyperechoic compared to normal muscle (Fig.
4).
PATHOLOGIC FINDINGS
Muscular injuries can be grouped in direct injuries,
occurring from a direct stress,
or indirect injuries,
which results from excessive load on the muscle,
usually leading to injuries at the weakest points (e.g.
the musculotendinous junction).
-Direct injuries
These...
Conclusion
Although the clinical examination is the most important factor in muscular injuries evaluation,
imaging plays also a very important role,
allowing the injury confirmation,
its characterization and classification,
the lesion follow up and the assessment of complications.
Despite MRI has been considered the Gold-standard technique in muscle injuries,
US is itself a great method in the initial assessment and follow up of these lesions.
Its high spatial resolution and the dynamic study allow the detection of very small ruptures,
sometimes more accurately than MRI.
Its...
References
- A Corazza et al,
Muscles,
Ligaments and tendons Journal,
2013; 3(4):331-336.
- A.
Corazza et al,
Thigh muscles injuries in professional football players,
EPOS,
ESSR 2013.
- Ali Guermazi et al,
Imaging of muscle injuries in sports Medicine,
Radiology,
2017,
282 (3): 646-663.
- Comin J et al.
Am J Sports Med,
2013,
41:111-115.
- Connel DA et al,
Longitudinal study comparing sonographic and MRI assessments of acute and healing hamstring injuries,
AJR,
2004 Oct;183(4):975-84.
- F.
Draghi et al,
Muscle injuries: ultrasound evaluation...