الفهرس 
Muscle injuriesOnly 14 pages are availabe for public view
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Abstract
According to the pathogenetic mechanism, muscle injuries are classified as extrinsic injuries such as contusions and penetrating wounds, where the site of the lesion corresponds to the site of impact, and intrinsic injuries caused by contraction and contemporary elongation of the muscles leading to muscle fiber destruction at the myotendinous junction.
Skeletal muscle is the largest tissue mass of the human body, accounting for almost 50% of the weight of an average person. Lower limb fractures account for approximately one third of all fractures and may result in substantial mortality and morbidity.
Imaging can be useful to confirm an injury and define the exact location and muscles involved. It can assess the extent of injury and thus guide treatment. Imaging can help to identify complications after muscle injury that will require surgical intervention or require a delay in return to physical activity.
US examination of a patient with suspected muscle injury should always be preceded by an accurate reporting of the patient’s medical history including the mechanism of injury, symptoms, possible pain and loss of strength, and a careful clinical evaluation which may reveal the presence of masses or morphological alterations of the of anatomical part under consideration.
The resolution of ultrasound images has improved rapidly in recent years. Ultrasound machines with high-frequency (12e15 MHz) linear array transducers provide better image resolution and are widely used to evaluate superficial soft tissue structures such as muscle, tendon, ligament, and bursa. They are therefore commonly referred to as musculoskeletal ultrasound (MSUS) machines
Clinicians are increasingly using ultrasound (US) to guide the return-to activity time frame. An early return to activity is an important factor for any patient but is a critical factor for an elite athlete who wants to minimize the absence from training and competition.
The study is aimed to assess muscle injury associated with upper and lower closed limb fracture using ultrasound, and to develop ultrasound classification criteria for muscle injury.
This study is a prospective observational study, was conducted on 30 patients with closed limb fracture and muscle injury at Diagnostic Radiology Department, Ain Shams hospitals, through of 3 months.
The main results of the study revealed that:
• Age of the patients ranged from 19 to 73 years with mean age was 46.0±15.51 years.
• There were 18 (60%) males and 12 (40%) females with a male to female ratio of 1.5:1.
• Sixteen (53.3%) patients had upper limb injury and the other 14 (46.7%) had lower limb injury. Focal fibre rupture was observed in 13 (43.3%) cases.
• The mean percent of injured area was 23.67± 6.69%. in two (6.7%) cases, the injured area exceeded 30%
• The mean size of muscle hematoma was 25.16± 6.99 mm with range from 15 mm to 36 mm. The hematoma showed a honeycombed pattern in 3 (10%) cases.
• Vascular rupture was observed in 7 (23.3%) cases.
• The mean muscle thickness was 10.60± 3.98 mm with range from 5 mm to 17 mm.
• 12 (40%) cases showed increase in the diameter of muscle growth rate exceeding 50%.
• 12 (40%) cases showed an increase in the area growth rate of the muscle exceeding 50%.
• 26 (86.7%) cases had grade I, 3 (10%) cases had grade II and only one case had grade III.
Based on our results we recommend for further studies on larger patients and longer period of follow up to emphasize our conclusion.