Diagnostic Imaging of Muscle Injuries in Sports Medicine: New Concepts and Radiological Approach

Purpose of review: The aim of this review is to discuss the most common muscle injuries in sports, state-of-the-science classification, and return to play recommendations, focused on the role of imaging findings and new techniques. Recent findings: New efforts for more accurate classification and grading system resulted in detailed and precise terminology, such as showed in the Munich consensus and later by the British Classification system. Advanced imaging, such as MR T2 mapping, MR spectroscopy, and DTI may give further information on injured muscles’ functional status and fibers’ recovery, but it still faces cost and availability issues, which reduce its application in the professional athletes setting. Summary: Muscle injuries in sports usually result in time lost from training and competition. High-level athletes may miss several matches or competition per season, with significant economic impact for clubs and sponsors. Accurate muscle injury classification with clinical evaluation and imaging techniques is vital for proper treatment and season planning. MRI is the method of choice to evaluate the location, size, and characteristics of the injury and it is crucial for classification and treatment planning. Ultrasound imaging performed by experienced radiologists, especially inside training/recovery facilities of professional teams, is useful to diagnose acute injuries and in the follow-up of the athletes’ recovery by seriated imaging.