title: Imaging and ultrasound-guided steroid injection of internal oblique muscle strains in baseball pitchers.
abstract: BACKGROUND
  Internal oblique muscle injuries are common in professional baseball pitchers and may require a prolonged convalescence of up to 10 weeks. Most strains can be diagnosed clinically, but imaging can be helpful to assess the severity of injury, which may predict recovery and return to play.
  
  
  OBJECTIVE
  Ultrasound-guided injection of steroid and local anesthetic into the muscle tear can speed recovery and subsequent return to play.
  
  
  METHODS
  Case series; Level of evidence, 4.
  
  
  METHODS
  Three professional baseball pitchers with acute tears of the internal oblique muscle confirmed by magnetic resonance imaging underwent ultrasound-guided injection of steroid and local anesthetic.
  
  
  RESULTS
  All 3 patients experienced significant pain relief within a few days of the injection and were able to pitch at full speed within 3 weeks of injury (mean, 21 days) and return to able status by 5 weeks (mean, 30.7 days). The 3 athletes continue to pitch in Major League Baseball 36 months, 36 months, and 14 months, respectively, after injury, and none have sustained reinjury during this time.
  
  
  CONCLUSIONS
  Therapeutic injection of steroids and anesthetic under ultrasound guidance appears to speed recovery and rehabilitation in professional baseball pitchers with acute side strains.
authors.affiliation: Stanford University Medical Center, Department of Radiology, 300 Pasteur Drive, Room S-062A, Stanford, CA 94305, USA. kate.stevens@stanford.edu
authors.forename: Kathryn J
authors.initials: KJ
authors.lastname: Stevens
authors.forename: Jana M
authors.initials: JM
authors.lastname: Crain
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Akizuki
authors.forename: Christopher F
authors.initials: CF
authors.lastname: Beaulieu
mesh_terms: D000328:Adult; D001265:Athletic Injuries / Q000000981:diagnostic imaging / Q000188:drug therapy*; D054874:Athletic Performance; D001484:Baseball / Q000293:injuries*; D002045:Bupivacaine / Q000008:administration & dosage / Q000627:therapeutic use; D003907:Dexamethasone / Q000008:administration & dosage*; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging / Q000293:injuries*; D010146:Pain / Q000188:drug therapy; D020127:Recovery of Function; D013180:Sprains and Strains / Q000000981:diagnostic imaging / Q000188:drug therapy*; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D003907:Dexamethasone; D002045:Bupivacaine