Rectus abdominis strain - ultrasound

Case contributed by Maulik S Patel
Diagnosis certain

Presentation

One week before presentation, the patient had sudden onset left-sided lower abdominal pain while playing volleyball.

Patient Data

Age: 25 years
Gender: Male
ultrasound

At the site of pain pointed out by the patient, there is diffuse edema of the left rectus abdominis muscle. There is an area of loss of muscle echopattern (about 24 x 11 x 8 mm) filled with fluid. There is no collection external to the muscle belly, within the rectus sheath. Left inferior epigastric vessels are patent. A comparison was done with the contralateral muscle as well as ipsilateral muscle at asymptomatic level.

There was no intra-abdominal abnormality on ultrasound (Images not uploaded).

Case Discussion

A young male was referred for an abdominal ultrasound. The pain started while playing volleyball about one week back. The patient has right arm dominance and pain was in the left lower abdomen. Ultrasound shows left rectus abdominis injury with intramuscular hematoma, consistent with at least a grade II strain.

In volleyball, rectus abdominis muscle injury occurs on the non-dominant side. The patient in this case was not a professional volleyball player.

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