High risk of underestimating the real extent of an high degree muscle strain when using only ultrasound imaging, especially in acute phase; always use power-doppler integration to evaluate the intramuscular and perifascial edema. It’s often frequent to find also a subcutaneous fat pad inflamatory reaction adjacent to the site of injury. Never forget that the more muscle edema is present, the higher echogenicity you’ll find.

   High degree strain injury of the adductor longus muscle: dynamic ultrasound examination.