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Sonography and MRI of Rectus Abdominis Muscle Strain in Elite Tennis Players

David Connell1, Kaline Ali1, Malika Javid1, Phil Bell2, Mark Batt3 and Simon Kemp4

1 Department of Radiology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, London HA7 4LP, United Kingdom.
2 BUPA Wellness, Barbican, United Kingdom.
3 Centre for Sports Medicine, Queens Medical Center, Nottingham, United Kingdom.
4 Football Union Rugby House, Twickenham, United Kingdom.


Figure 1
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  		Fig. 1A —24-year-old professional male tennis player. Transverse sonograms show hypertrophy of left rectus abdominis (A) relative to right rectus abdominis (B).

 

Figure 2
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  		Fig. 1B —24-year-old professional male tennis player. Transverse sonograms show hypertrophy of left rectus abdominis (A) relative to right rectus abdominis (B).

 

Figure 3
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  		Fig. 2A —16-year-old elite male tennis player. Sonogram shows focal area of myofibril disruption of deep and lower part of left rectus abdominis after forehand smash.

 

Figure 4
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  		Fig. 2B —16-year-old elite male tennis player. Color Doppler sonogram shows blood vessels infiltrating site of muscle tear.

 

Figure 5
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  		Fig. 3A —21-year-old male tennis player after serving injury. Axial proton density (TR/TE, 4,000/30) (A) and axial STIR (3,500/30 [B]; inversion time, 130 msec) images show hypertrophy of left rectus abdominis with focal area of hyperintensity (arrow) compatible with muscle edema, hemorrhage, and fibril disruption.

 

Figure 6
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  		Fig. 3B —21-year-old male tennis player after serving injury. Axial proton density (TR/TE, 4,000/30) (A) and axial STIR (3,500/30 [B]; inversion time, 130 msec) images show hypertrophy of left rectus abdominis with focal area of hyperintensity (arrow) compatible with muscle edema, hemorrhage, and fibril disruption.

 

Figure 7
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  		Fig. 4 —Coronal MR image (TR/TE 4,000/30) in 19-year-old elite male tennis player shows left lower rectus abdominis tear (arrow) after forehand injury.

 

Figure 8
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  		Fig. 5 —Transverse section through anterior abdominal wall.

 

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