Musculotendinous Disorders of the Abdomen and Pelvis

Abstract

Musculotendinous disorders of the abdomen and pelvis are common causes of pain in both athletes and nonathletes. Magnetic resonance imaging (MRI) is the modality of choice in the work-up of these patients. This article focuses on the MRI appearance of normal anatomy and spectrum of musculotendinous disorders in the abdomen and pelvis including muscle strains and tears, avulsions and apophysitis, muscular contusions, athletic groin pain, and gluteal aponeurotic/proximal iliotibial band injuries. Normal biomechanics and injury mechanisms are discussed.

Keywords

musculotendinous disorders - abdominal wall imaging - side strain - athletic groin injury - athletic pubalgia

• References

• 1 Baumann DP, Butler CE. Lateral abdominal wall reconstruction. Semin Plast Surg 2012; 26 (01) 40-48
• 2 Connell DA, Jhamb A, James T. Side strain: a tear of internal oblique musculature. AJR Am J Roentgenol 2003; 181 (06) 1511-1517
• 3 Stensby JD, Baker JC, Fox MG. Athletic injuries of the lateral abdominal wall: review of anatomy and MR imaging appearance. Skeletal Radiol 2016; 45 (02) 155-162
• 4 Gyftopoulos S, Rosenberg ZS, Schweitzer ME, Bordalo-Rodrigues M. Normal anatomy and strains of the deep musculotendinous junction of the proximal rectus femoris: MRI features. AJR Am J Roentgenol 2008; 190 (03) W182–W186
• 5 Overdeck KH, Palmer WE. Imaging of hip and groin injuries in athletes. Semin Musculoskelet Radiol 2004; 8 (01) 41-55
• 6 Maquirriain J, Ghisi JP. Uncommon abdominal muscle injury in a tennis player: internal oblique strain. Br J Sports Med 2006; 40 (05) 462-463
• 7 Stevens KJ, Crain JM, Akizuki KH, Beaulieu CF. Imaging and ultrasound-guided steroid injection of internal oblique muscle strains in baseball pitchers. Am J Sports Med 2010; 38 (03) 581-585
• 8 Humphries D, Jamison M. Clinical and magnetic resonance imaging features of cricket bowler's side strain. Br J Sports Med 2004; 38 (05) E21
• 9 Belair JA, Hegazi TM, Roedl JB, Zoga AC, Omar IM. Core injuries remote from the pubic symphysis. Radiol Clin North Am 2016; 54 (05) 893-911
• 10 Garrett Jr WE. Muscle strain injuries: clinical and basic aspects. Med Sci Sports Exerc 1990; 22 (04) 436-443
• 11 Mueller-Wohlfahrt HW, Haensel L, Mithoefer K. , et al. Terminology and classification of muscle injuries in sport: the Munich consensus statement. Br J Sports Med 2013; 47 (06) 342-350
• 12 Hébert KJ, Laor T, Divine JG, Emery KH, Wall EJ. MRI appearance of chronic stress injury of the iliac crest apophysis in adolescent athletes. AJR Am J Roentgenol 2008; 190 (06) 1487-1491
• 13 Pisacano RM, Miller TT. Comparing sonography with MR imaging of apophyseal injuries of the pelvis in four boys. AJR Am J Roentgenol 2003; 181 (01) 223-230
• 14 Rossi F, Dragoni S. Acute avulsion fractures of the pelvis in adolescent competitive athletes: prevalence, location and sports distribution of 203 cases collected. Skeletal Radiol 2001; 30 (03) 127-131
• 15 Rimola J, Perendreu J, Falcó J, Fortuño JR, Massuet A, Branera J. Percutaneous arterial embolization in the management of rectus sheath hematoma. AJR Am J Roentgenol 2007; 188 (06) W497-W502
• 16 Weir A, Brukner P, Delahunt E. , et al. Doha agreement meeting on terminology and definitions in groin pain in athletes. Br J Sports Med 2015; 49 (12) 768-774
• 17 Blazina ME. The “hip-pointer,” a term to describe a specific kind of athletic injury. Calif Med 1967; 106 (06) 450
• 18 Palisch A, Zoga AC, Meyers WC. Imaging of athletic pubalgia and core muscle injuries: clinical and therapeutic correlations. Clin Sports Med 2013; 32 (03) 427-447
• 19 Omar IM, Zoga AC, Kavanagh EC. , et al. Athletic pubalgia and “sports hernia”: optimal MR imaging technique and findings. Radiographics 2008; 28 (05) 1415-1438
• 20 Norton-Old KJ, Schache AG, Barker PJ, Clark RA, Harrison SM, Briggs CA. Anatomical and mechanical relationship between the proximal attachment of adductor longus and the distal rectus sheath. Clin Anat 2013; 26 (04) 522-530
• 21 Huang BK, Campos JC, Michael Peschka PG. , et al. Injury of the gluteal aponeurotic fascia and proximal iliotibial band: anatomy, pathologic conditions, and MR imaging. Radiographics 2013; 33 (05) 1437-1452
• 22 Chopra A, Robinson P. Imaging athletic groin pain. Radiol Clin North Am 2016; 54 (05) 865-873
• 23 Zoga AC, Kavanagh EC, Omar IM. , et al. Athletic pubalgia and the “sports hernia”: MR imaging findings. Radiology 2008; 247 (03) 797-807
• 24 Koulouris G. Imaging review of groin pain in elite athletes: an anatomic approach to imaging findings. AJR Am J Roentgenol 2008; 191 (04) 962-972
• 25 Cunningham PM, Brennan D, O'Connell M, MacMahon P, O'Neill P, Eustace S. Patterns of bone and soft-tissue injury at the symphysis pubis in soccer players: observations at MRI. AJR Am J Roentgenol 2007; 188 (03) W291-6
• 26 Armstrong P, Saxton H. Ilio-psoas bursa. Br J Radiol 1972; 45 (535) 493-495
• 27 Harper MC, Schaberg JE, Allen WC. Primary iliopsoas bursography in the diagnosis of disorders of the hip. Clin Orthop Relat Res 1987; (221) 238-241
• 28 Steinbach LS, Schneider R, Goldman AB, Kazam E, Ranawat CS, Ghelman B. Bursae and abscess cavities communicating with the hip. Diagnosis using arthrography and CT. Radiology 1985; 156 (02) 303-307
• 29 Pelsser V, Cardinal E, Hobden R, Aubin B, Lafortune M. Extraarticular snapping hip: sonographic findings. AJR Am J Roentgenol 2001; 176 (01) 67-73
• 30 Sher I, Umans H, Downie SA, Tobin K, Arora R, Olson TR. Proximal iliotibial band syndrome: what is it and where is it?. Skeletal Radiol 2011; 40 (12) 1553-1556