about ultrasound and mri findings of vastus lateralis injury
This is the case of a young rugby player presenting an high degree strain of the vastus lateralis muscle at its proximal insertion, togheter with an aponeurotic fascial injury on the subcutaneous lateral side.
I always suggest to perform both the Mri and ultrasound investigations; with the Mri exam it is evident the bone marrow edema, due to the avulsion injury at the intertrochanteric line, suspected during the clinical evaluation but impossible to see on ultrasound exam.
Coronal (left) and Sagittal (right) PD-Fs Mri scans (1.5 Tesla).
Axial PD-Fs Mri scan (1.5 Tesla). The bone marrow edema and the avulsion injury are evident.
about ultrasound monitoring of muscle injury remodelling phase
In my recent post Ultrasound Muscle Injuries Monitoring I showed the importance of the dynamic ultrasound and elastosonography exam in the study of the granulation tissue at the site of injury during the rehabilitation program.
Today I want to remind you to take care about muscle also after the final phases of remodeling (3–6 months after trauma), in which maturation of the regenerating fibers into a functional contractile unit takes place.
Axial (left) and Coronal (right) Mri scans of a late left biceps femoris injury evaluation (1.5 Tesla).
In these cases the Mri exam is less sensistive than ultrasound imaging; don’t forget to always perform both imaging modalities.
The patient suspected a reinjury in the same site of a previous trauma; first evaluation was made with an ultraportable device.
The power-doppler exam togheter with the elastosonography evaluation, show an incomplete scar maturation.
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.
Coronal (left) and Sagittal PdwSpair Mri scans (1.5 Tesla) of the same patient.