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Sonographic Appearance of Side Strain Injury

Haron Obaid1, Andrew Nealon2 and David Connell3

1 Department of Radiology, Doncaster and Bassetlaw National Health Service Foundation Trust, Armthorpe Rd., Doncaster, DN2 5LT, United Kingdom.
2 Hampshire Cricket, The Rose Bowl, Southampton, Hampshire, United Kingdom.
3 Royal National Orthopaedic Hospital, Stanmore, Middlesex, United Kingdom.


Figure 1
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  		Fig. 1 —Drawing shows normal anatomy of abdominal wall muscles. External oblique muscle fibers have superolateral and internal oblique muscle fibers superomedial orientation.

 

Figure 2
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  		Fig. 2A —21-year-old man with normal internal oblique muscle. Sonograms in longitudinal (A) and transverse (B) planes show linear fibrillar echogenic pattern of external oblique (black arrow, B) and internal oblique (white arrow) muscles.

 

Figure 3
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  		Fig. 2B —21-year-old man with normal internal oblique muscle. Sonograms in longitudinal (A) and transverse (B) planes show linear fibrillar echogenic pattern of external oblique (black arrow, B) and internal oblique (white arrow) muscles.

 

Figure 4
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  		Fig. 3 —22-year-old man with internal oblique muscle tear (side strain) at its rib origin. Sonogram shows tear as focal hypoechoic area (arrow) measuring 22 mm in longitudinal plane.

 

Figure 5
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  		Fig. 4A —24-year-old man with side strain (not in study group). STIR MR images in coronal oblique (A) and axial (B) planes show focal area (arrow) of fluid signal intensity with edema in fibers of internal oblique muscle at its rib origin, findings consistent with side strain.

 

Figure 6
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  		Fig. 4B —24-year-old man with side strain (not in study group). STIR MR images in coronal oblique (A) and axial (B) planes show focal area (arrow) of fluid signal intensity with edema in fibers of internal oblique muscle at its rib origin, findings consistent with side strain.

 

Figure 7
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  		Fig. 5 —23-year-old man with side strain. Sonographic image shows amount of fluid (arrow) at site of injury representing diagnostic challenge.

 

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