Fact-sheet: Muscle strain
Updated on 08/23/2017 at 7:15 AM
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Definition
Intrinsic muscle tear from a stretching mechanism resulting in muscle fiber injury.
Clinical features
Pain occurring during strenuous exertion, without direct trauma.
Ultrasound
First-line examination
Day 1: hemorrhage, tear.
Day 3: allows assessment of lesion length
Day 10: follow-up of evolution.
Semiology depends on grade (see classification).
MRI
Performed on Day 2 with follow-up at Day 10 Protocol: - Axial T1-weighted slices - Axial and aponeurosis-perpendicular T2-weighted slices Assesses the type of lesion, its grade, its length, and the presence of a peri-aponeurotic effusion. Semiology depends on grade (see classification).
Classification
Durey and Rodineau histological classification:
- Stage 0: reversible muscle fiber injury, without involvement of the supporting connective tissue (DOMS).
- Stage 1: irreversible injury to a few muscle fibers, without involvement of the supporting connective tissue ("minor strain").
- Stage 2: irreversible injury to a limited number of muscle fibers, with involvement of the supporting connective tissue ("significant strain").
- Stage 3: irreversible injury to numerous muscle fibers, with involvement of the supporting connective tissue and formation of a localized intramuscular hematoma ("tear" or "pull").
- Stage 4: partial or complete muscle rupture ("severe tear").