Calf Muscle Contusion

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Professional football player; contusion of soleus muscle at its proximal third, produced by a direct trauma during a match;  interstitial edema and hemorrhage is evident.

soleus-contusion

Multiplanar T2w Mri imaging (0.3 Tesla) of a soleus high degree contusive injury.

Despite of their appearence, contusions tend to have a recovery time significantly shorter then undirect traumas. In this case the athlete never missed a match.

A recognized complication of muscular contusion is myositis ossificans, so it’s very important the ultrasound monitoring.

Intramuscular haematoma and oedema at the postero-medial aspects of the soleus muscle are depicted, with post-traumatic hypervascularity.

Always perform both Mri and dynamic ultrasound imaging for a better definition  of this kind of injury.

Triceps Tendon Avulsion

This injury is considered in literature as the “least common of all tendon injuries”, and for this reason often misdiagnosed; I suggest always to pay attention when you find something calcific after a trauma, especially with ultrasound imaging.

Today I show you the case of complete triceps tendon avulsion occurred after a falling injury that had happened eight days back.

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Comparative examination between ultrasound scan and Sagittal T2w Mri Imaging (0.3 Tesla)

The X-ray examination still assumes great importance in this kind of injury.

triceps-tendon-avulsion-xray

Sagittal T2w Mri exam (0.3 Tesla) and plain radiograph of the same patient.

Dynamic Mri Study of Patella Baja

Dynamic Mri exam is crucial in many situations; in a previous post I have shown a dynamic Mri study of patellofemoral impingement with patella alta.
Take a look at this patient in which the suspected patella baja is well studied during flexion-extension active movements.

insall-salvati-001

The Insall-Salvati Index (ISI) and its modified version are used the same way on Mri studies as on plain radiographs.

Rember that in case of true patella baja, the patella remains engaged within the trochlear groove in full knee extension. The dynamic examination allows to appreciate the direct visualization of patellar and trochlear allignment for a more objective measurement, together with the others modalities. In this patient the dynamic examination shows a correct patellar positioning during active extension.