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Musculoskeletal
Diagnosis
Trauma
Introduction
Traumatic Injury, Special Topics
Muscle Injury
Muscle Injury
Kirkland W. Davis, MD, FACR; Kambiz Motamedi, MD, FACR; Andrew Sonin, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Synonyms

              • Muscle strain, tear, contusion, myotendinous injury, delayed-onset muscle soreness (DOMS)

            • Definitions

              • Injury occurring within muscle belly, at myotendinous junction (MTJ) or myofascial junction (MFJ)

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Ultrasonographic Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              CLINICAL ISSUES

                              • Presentation

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Reporting Tips

                                      Selected References

                                      1. Guermazi A et al: Imaging of muscle injuries in sports medicine: sports imaging series. Radiology. 285(3):1063, 2017
                                      2. Lutterbach-Penna RA et al: Ultrasound of the thigh: focal, compartmental, or comprehensive examination? AJR Am J Roentgenol. 203(5):1085-92, 2014
                                      3. Draghi F et al: Muscle injuries: ultrasound evaluation in the acute phase. J Ultrasound. 16(4):209-14, 2013
                                      4. Douis H et al: Imaging in the diagnosis, prognostication, and management of lower limb muscle injury. Semin Musculoskelet Radiol. 15(1):27-41, 2011
                                      5. Blankenbaker DG et al: Temporal changes of muscle injury. Semin Musculoskelet Radiol. 14(2):176-93, 2010
                                      6. Hasegawa K et al: Rupture of the pectoralis major: a case report and review. J Emerg Med. 38(2):196-200, 2010
                                      7. Andreisek G et al: T2*-weighted and arterial spin labeling MRI of calf muscles in healthy volunteers and patients with chronic exertional compartment syndrome: preliminary experience. AJR Am J Roentgenol. 193(4):W327-33, 2009
                                      8. Bley TA et al: Diffusion-weighted MR imaging in musculoskeletal radiology: applications in trauma, tumors, and inflammation. Magn Reson Imaging Clin N Am. 17(2):263-75, 2009
                                      9. Gielen JL et al: Chronic exertional compartment syndrome of the forearm in motocross racers: findings on MRI. Skeletal Radiol. 38(12):1153-61, 2009
                                      10. Le HB et al: Magnetic resonance imaging appearance of partial latissimus dorsi muscle tendon tear. Skeletal Radiol. 38(11):1107-10, 2009
                                      11. Shelly MJ et al: MR imaging of muscle injury. Magn Reson Imaging Clin N Am. 17(4):757-73, vii, 2009
                                      12. Williams MD et al: Fatty infiltration of the supraspinatus: a reliability study. J Shoulder Elbow Surg. 18(4):581-7, 2009
                                      13. Zvijac JE et al: Isolated tears of pectoralis minor muscle in professional football players: a case series. Am J Orthop (Belle Mead NJ). 38(3):145-7, 2009
                                      14. Gyftopoulos S et al: Normal anatomy and strains of the deep musculotendinous junction of the proximal rectus femoris: MRI features. AJR Am J Roentgenol. 190(3):W182-6, 2008
                                      15. Marqueste T et al: Comparative MRI analysis of T2 changes associated with single and repeated bouts of downhill running leading to eccentric-induced muscle damage. J Appl Physiol. 105(1):299-307, 2008
                                      16. Silder A et al: MR observations of long-term musculotendon remodeling following a hamstring strain injury. Skeletal Radiol. 37(12):1101-9, 2008
                                      17. Takase K: Isolated rupture of the teres major muscle. J Orthop Sports Phys Ther. 38(7):439, 2008
                                      18. Koh ES et al: Ultrasound of skeletal muscle injury. Semin Musculoskelet Radiol. 11(2):162-73, 2007
                                      19. O'Brien SD et al: MRI of quadratus femoris muscle tear: another cause of hip pain. AJR Am J Roentgenol. 189(5):1185-9, 2007
                                      20. Napier N et al: Muscle edema: classification, mechanisms, and interpretation. Semin Musculoskelet Radiol. 10(4):258-67, 2006
                                      21. Orchard J et al: Return to play following muscle strains. Clin J Sport Med. 15(6):436-41, 2005
                                      22. Yu JS et al: Common injuries related to weightlifting: MR imaging perspective. Semin Musculoskelet Radiol. 9(4):289-301, 2005
                                      23. Rybak LD et al: Magnetic resonance imaging of sports-related muscle injuries. Top Magn Reson Imaging. 14(2):209-19, 2003
                                      24. Boutin RD et al: Imaging of sports-related muscle injuries. Radiol Clin North Am. 40(2):333-62, vii, 2002
                                      25. Clarkson PM et al: Exercise-induced muscle damage in humans. Am J Phys Med Rehabil. 81(11 Suppl):S52-69, 2002
                                      26. Peetrons P: Ultrasound of muscles. Eur Radiol. 12(1):35-43, 2002
                                      27. Beiner JM et al: Muscle contusion injuries: current treatment options. J Am Acad Orthop Surg. 9(4):227-37, 2001
                                      28. May DA et al: Abnormal signal intensity in skeletal muscle at MR imaging: patterns, pearls, and pitfalls. Radiographics. 20 Spec No:S295-315, 2000
                                      29. Nguyen B et al: Pains, strains, and fasciculations: lower extremity muscle disorders. Magn Reson Imaging Clin N Am. 8(2):391-408, 2000
                                      30. Bergman AG et al: MR imaging of stress reactions, muscle injuries, and other overuse injuries in runners. Magn Reson Imaging Clin N Am. 7(1):151-74, ix, 1999
                                      31. Noonan TJ et al: Muscle strain injury: diagnosis and treatment. J Am Acad Orthop Surg. 7(4):262-9, 1999
                                      32. Schlegel TF et al: Role of MR imaging in the management of injuries in professional football players. Magn Reson Imaging Clin N Am. 7(1):175-90, ix, 1999
                                      33. Kneeland JP: MR imaging of muscle and tendon injury. Eur J Radiol. 25(3):198-208, 1997
                                      34. El-Khoury GY et al: Imaging of muscle injuries. Skeletal Radiol. 25(1):3-11, 1996
                                      35. Steinbach LS et al: Magnetic resonance imaging of muscle injuries. Orthopedics. 17(11):991-9, 1994
                                      36. De Smet AA: Magnetic resonance findings in skeletal muscle tears. Skeletal Radiol. 22(7):479-84, 1993
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Pathology

                                            • Clinical Issues

                                              • Diagnostic Checklist

                                                TERMINOLOGY

                                                • Synonyms

                                                  • Muscle strain, tear, contusion, myotendinous injury, delayed-onset muscle soreness (DOMS)

                                                • Definitions

                                                  • Injury occurring within muscle belly, at myotendinous junction (MTJ) or myofascial junction (MFJ)

                                                IMAGING

                                                • General Features

                                                  • Radiographic Findings

                                                    • CT Findings

                                                      • MR Findings

                                                        • Ultrasonographic Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Staging, Grading, & Classification

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Natural History & Prognosis

                                                                      • Treatment

                                                                        DIAGNOSTIC CHECKLIST

                                                                        • Reporting Tips

                                                                          Selected References

                                                                          1. Guermazi A et al: Imaging of muscle injuries in sports medicine: sports imaging series. Radiology. 285(3):1063, 2017
                                                                          2. Lutterbach-Penna RA et al: Ultrasound of the thigh: focal, compartmental, or comprehensive examination? AJR Am J Roentgenol. 203(5):1085-92, 2014
                                                                          3. Draghi F et al: Muscle injuries: ultrasound evaluation in the acute phase. J Ultrasound. 16(4):209-14, 2013
                                                                          4. Douis H et al: Imaging in the diagnosis, prognostication, and management of lower limb muscle injury. Semin Musculoskelet Radiol. 15(1):27-41, 2011
                                                                          5. Blankenbaker DG et al: Temporal changes of muscle injury. Semin Musculoskelet Radiol. 14(2):176-93, 2010
                                                                          6. Hasegawa K et al: Rupture of the pectoralis major: a case report and review. J Emerg Med. 38(2):196-200, 2010
                                                                          7. Andreisek G et al: T2*-weighted and arterial spin labeling MRI of calf muscles in healthy volunteers and patients with chronic exertional compartment syndrome: preliminary experience. AJR Am J Roentgenol. 193(4):W327-33, 2009
                                                                          8. Bley TA et al: Diffusion-weighted MR imaging in musculoskeletal radiology: applications in trauma, tumors, and inflammation. Magn Reson Imaging Clin N Am. 17(2):263-75, 2009
                                                                          9. Gielen JL et al: Chronic exertional compartment syndrome of the forearm in motocross racers: findings on MRI. Skeletal Radiol. 38(12):1153-61, 2009
                                                                          10. Le HB et al: Magnetic resonance imaging appearance of partial latissimus dorsi muscle tendon tear. Skeletal Radiol. 38(11):1107-10, 2009
                                                                          11. Shelly MJ et al: MR imaging of muscle injury. Magn Reson Imaging Clin N Am. 17(4):757-73, vii, 2009
                                                                          12. Williams MD et al: Fatty infiltration of the supraspinatus: a reliability study. J Shoulder Elbow Surg. 18(4):581-7, 2009
                                                                          13. Zvijac JE et al: Isolated tears of pectoralis minor muscle in professional football players: a case series. Am J Orthop (Belle Mead NJ). 38(3):145-7, 2009
                                                                          14. Gyftopoulos S et al: Normal anatomy and strains of the deep musculotendinous junction of the proximal rectus femoris: MRI features. AJR Am J Roentgenol. 190(3):W182-6, 2008
                                                                          15. Marqueste T et al: Comparative MRI analysis of T2 changes associated with single and repeated bouts of downhill running leading to eccentric-induced muscle damage. J Appl Physiol. 105(1):299-307, 2008
                                                                          16. Silder A et al: MR observations of long-term musculotendon remodeling following a hamstring strain injury. Skeletal Radiol. 37(12):1101-9, 2008
                                                                          17. Takase K: Isolated rupture of the teres major muscle. J Orthop Sports Phys Ther. 38(7):439, 2008
                                                                          18. Koh ES et al: Ultrasound of skeletal muscle injury. Semin Musculoskelet Radiol. 11(2):162-73, 2007
                                                                          19. O'Brien SD et al: MRI of quadratus femoris muscle tear: another cause of hip pain. AJR Am J Roentgenol. 189(5):1185-9, 2007
                                                                          20. Napier N et al: Muscle edema: classification, mechanisms, and interpretation. Semin Musculoskelet Radiol. 10(4):258-67, 2006
                                                                          21. Orchard J et al: Return to play following muscle strains. Clin J Sport Med. 15(6):436-41, 2005
                                                                          22. Yu JS et al: Common injuries related to weightlifting: MR imaging perspective. Semin Musculoskelet Radiol. 9(4):289-301, 2005
                                                                          23. Rybak LD et al: Magnetic resonance imaging of sports-related muscle injuries. Top Magn Reson Imaging. 14(2):209-19, 2003
                                                                          24. Boutin RD et al: Imaging of sports-related muscle injuries. Radiol Clin North Am. 40(2):333-62, vii, 2002
                                                                          25. Clarkson PM et al: Exercise-induced muscle damage in humans. Am J Phys Med Rehabil. 81(11 Suppl):S52-69, 2002
                                                                          26. Peetrons P: Ultrasound of muscles. Eur Radiol. 12(1):35-43, 2002
                                                                          27. Beiner JM et al: Muscle contusion injuries: current treatment options. J Am Acad Orthop Surg. 9(4):227-37, 2001
                                                                          28. May DA et al: Abnormal signal intensity in skeletal muscle at MR imaging: patterns, pearls, and pitfalls. Radiographics. 20 Spec No:S295-315, 2000
                                                                          29. Nguyen B et al: Pains, strains, and fasciculations: lower extremity muscle disorders. Magn Reson Imaging Clin N Am. 8(2):391-408, 2000
                                                                          30. Bergman AG et al: MR imaging of stress reactions, muscle injuries, and other overuse injuries in runners. Magn Reson Imaging Clin N Am. 7(1):151-74, ix, 1999
                                                                          31. Noonan TJ et al: Muscle strain injury: diagnosis and treatment. J Am Acad Orthop Surg. 7(4):262-9, 1999
                                                                          32. Schlegel TF et al: Role of MR imaging in the management of injuries in professional football players. Magn Reson Imaging Clin N Am. 7(1):175-90, ix, 1999
                                                                          33. Kneeland JP: MR imaging of muscle and tendon injury. Eur J Radiol. 25(3):198-208, 1997
                                                                          34. El-Khoury GY et al: Imaging of muscle injuries. Skeletal Radiol. 25(1):3-11, 1996
                                                                          35. Steinbach LS et al: Magnetic resonance imaging of muscle injuries. Orthopedics. 17(11):991-9, 1994
                                                                          36. De Smet AA: Magnetic resonance findings in skeletal muscle tears. Skeletal Radiol. 22(7):479-84, 1993