Derek R Armfield MDab David Hyun Min Kim MDc Jeffrey D Towers MDa James P Bradley MDd Douglas D Robertson MD PhDab

aDepartment of Radiology, University of Pittsburgh Medical Center, 200 Lothrop Street, Pittsburgh, PA 15213, USA

bjefferson Regional Medical Center, 565 Coal Velley Road, Pittsburgh, PA 15236, USA cUniversity of Southern California, Department of Radiology, 1500 San Pablo Street, Los Angeles, CA 90033, USA

dBurke and Bradley Orthopaedics and Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, 200 Lothrop Street, Pittsburgh, PA 15213, USA

Muscle injuries are common and often occur during sport or training with over 90% caused by excessive strain or contusion [1]. A 5-year study of European soccer players showed muscle strain represented 30% of injuries with the quadriceps (32%), hamstring (28%), adductor (19%), and gastrocnemius (12%) muscle injuries being the most common [2]. Treatment typically consists of rest, ice, compression, elevation, and stretching and rehabilitation. Programs are designed to treat and prevent, as those with prior injuries are prone to recurrence. This problem is particularly important in elite athletes where decisions regarding return to play and player performance can have significant financial or strategic consequences for the player and team.

This paper reviews the basic imaging techniques and the pertinent findings associated with common muscle injuries of the lower extremity, and emphasizes the imaging features, which can help guide treatment and offer prognosis. A general overview of muscle injury and imaging modalities is provided followed by a more detailed analysis of injuries to specific muscle groups of the lower extremity including the hamstrings, quadriceps, adductors, and lower leg muscles.

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