Weerakkody Y, Knipe H, Kang O, Delayed onset muscle soreness. Reference article, Radiopaedia.org (Accessed on 16 Feb 2025) https://doi.org/10.53347/rID-29073
Patients may have an ache in affected muscles with reduced strength 4.
Pathology
DOMS is thought to occur from the reversible microstructural muscle injury that is followed by an inflammatory process and subsequent shifts of fluid and electrolytes. There is usually no permanent damage to muscle function. It can affect single or multiple muscles, or muscle groups 6.
Serology
serum CK levels are often elevated
Radiographic features
Ultrasound
Most commonly DOMS presents as 5:
diffuse, well-defined hyperechoic regions within muscle
increased muscle size
minimal hyperemia
MRI
T2/STIR: affected muscles are high signal and this may persist for months following resolution of symptoms 4
4. Robert Pedowitz (Editor), Donald Resnick (Editor), Christine B. Chung (Editor). Magnetic Resonance Imaging in Orthopedic Sports Medicine. (2009) ISBN: 0387488979
5. Longo V, Jacobson J, Fessell D, Mautner K. Ultrasound Findings of Delayed-Onset Muscle Soreness. Journal of Ultrasound in Medicine. 2016;35(11):2517-21. doi:10.7863/ultra.15.12066
6. Hotfiel T, Freiwald J, Hoppe M et al. Advances in Delayed-Onset Muscle Soreness (DOMS): Part I: Pathogenesis and Diagnostics. Sportverletz Sportschaden. 2018;32(04):243-50. doi:10.1055/a-0753-1884