title: Value of sonography combined with clinical assessment to evaluate muscle injury severity in athletes.
abstract: BACKGROUND
  Predicting when an athlete can return to sport after muscle injury is a major concern.
  
  
  OBJECTIVE
  To determine whether combining objective clinical and ultrasound findings at presentation accurately predicted time to sport resumption in athletes with muscle injuries.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  Sports medicine clinic.
  
  
  METHODS
  A total of 93 consecutive patients, 87 male and 6 female, were seen over a 1-year period for sudden-onset muscle pain while engaging in a sporting activity within the last 5 days and inability to continue the training session or game.
  
  
  METHODS
  Standardized physical examination and sonogram.
  
  
  METHODS
  Statistical associations between clinical and sonographic features at presentation and time to sport resumption (<40 days or ≥ 40 days) were evaluated using multivariate models. Correlations between time to sport resumption predicted by a sports medicine specialist and actual time to sport resumption were evaluated using the Spearman rank correlation coefficient.
  
  
  RESULTS
  The 93 patients had 95 injuries, caused by muscle contraction in 86 cases and impact in 9 cases. Only 7 injuries had normal sonogram findings. Late sport resumption was associated with 4 clinical criteria (bruising, tenderness to palpation, range-of-motion limitation compared with the other limb, and increased pain with isometric contraction during passive limb straightening) and 4 sonographic criteria (disorganized fibrous tissue, intramuscular hematoma, intermuscular hematoma, and power Doppler signal). The Spearman rank correlation coefficient between predicted and actual times was 0.669 (P < .0001) for mild exercise resumption and 0.804 (P < .0001) for full sport resumption.
  
  
  CONCLUSIONS
  A combination of physical and sonographic data collected during the acute phase of sport-related muscle injury was effective in predicting time to sport resumption.
authors.affiliation: Department of Rheumatology, Cavale Blanche Teaching Hospital, Brest Cedex, France.
authors.forename: Yannick
authors.initials: Y
authors.lastname: Guillodo
authors.forename: Ronan
authors.initials: R
authors.lastname: Bouttier
authors.forename: Alain
authors.initials: A
authors.lastname: Saraux
mesh_terms: D000293:Adolescent; D000328:Adult; D056352:Athletes; D001265:Athletic Injuries / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D015331:Cohort Studies; D003288:Contusions / Q000175:diagnosis / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000293:injuries*; D017695:Soft Tissue Injuries / Q000175:diagnosis / Q000000981:diagnostic imaging; D013177:Sports; D013180:Sprains and Strains / Q000175:diagnosis / Q000000981:diagnostic imaging; D016896:Treatment Outcome; D014463:Ultrasonography; D055815:Young Adult