Muscle tear

Last revised by Dai Roberts on 20 Jan 2023

Citation, DOI, disclosures and article data

Citation:

Knipe H, Roberts D, Baba Y, et al. Muscle tear. Reference article, Radiopaedia.org (Accessed on 19 Apr 2024) https://doi.org/10.53347/rID-68411

DOI:

https://doi.org/10.53347/rID-68411

Permalink:

https://radiopaedia.org/articles/68411

rID:

68411

Article created:

29 May 2019, Henry Knipe ◉ ◈

Disclosures:

At the time the article was created Henry Knipe had no recorded disclosures.

View Henry Knipe's current disclosures

Last revised:

20 Jan 2023, Dai Roberts ◉

Disclosures:

At the time the article was last revised Dai Roberts had no financial relationships to ineligible companies to disclose.

View Dai Roberts's current disclosures

Revisions:

16 times, by 10 contributors - see full revision history and disclosures

Systems:

Musculoskeletal, Trauma

Tags:

sports, sports medicine, sports injuries, cases, case2

Synonyms:

Muscle strain
Muscle strains
Muscle tears
Muscle rupture
Muscle ruptures

Muscle tears or strains are common injuries, both in athletes and non-athletes.

Muscle strain is a term that is used variably clinically and in the medical literature. The Munich consensus statement (expert level evidence) states muscle tear is the preferred term denoting "structural injuries of muscle fibres/bundles leading to loss of continuity and contractile properties" ¹.

Pathology

Muscle tears are indirect muscle injury that occurs in eccentric contraction during sprinting or stretching ². Most commonly these injuries occur at the myotendinous junction (MTJ) but can also be peripheral (i.e. myofascial) ³.

Location

Muscles of the lower limbs are most at risk of injury, with the biceps femoris the most commonly injured followed by rectus femoris and gastrocnemius muscles ^2,3.

Radiographic features

Ultrasound

Ultrasound examination may be normal or in low-grade injuries demonstrate focal or diffuse regions of increased echogenicity. Fibre disruption is characterised by well-defined hypoechoic/anechoic regions. Disruption at the myofascial junction or myotendinous junction may be present ¹.

MRI

MRI features corresponding to clinical grades of injury are ¹:

grade 1: T2 high signal with a feathery appearance (usually centred on the MTJ) representing oedema +/- thickening and high signal of the intramuscular tendon but without laxity +/- mild perifascial fluid
grade 2: above features with fibre disruption characterised by high T2 signal and local distortion +/- intramuscular tendon high signal with or without thickening, laxity or partial disruption +/- moderate-severe perifascial fluid
grade 3: complete disruption +/- retraction/laxity with local haematoma