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Post exercise muscle injury

Case contributed by Andrew Lawson
Diagnosis almost certain

Presentation

Pain in the left thigh after long cycle.

Patient Data

Age: 50
Gender: Male
mri

Extensive gross muscular edema and swelling is identified in the anterior compartment of the left thigh, involving almost the entirety of vastus medialis, and 70 - 80% of vastus lateralis and vastus intermedius. Rectus femoris is spared. Thin layer of fluid tracks along fascial planes between the anterior compartment musculature. No focal muscular or myotendinous junction tear. No signal abnormality identified in muscle bellies in the posterior or medial compartments of the left thigh. Incompletely imaged on the coronal sequence there is evidence of less pronounced muscular edema in the contralateral right vastus medialis. No mass lesion. No bone marrow edema.

Conclusion Appearance is consistent with exercise induced muscle edema/injury.

Case Discussion

Biochemically has elevated creatine kinase.

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