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Rectus abdominis muscle tear diagnosed with sonography and its conservative management

  • Ashley N. RuffEmail author
  • Stacey M. Cornelson
  • Austin S. Panter
  • Norman W. Kettner
Case Report

Abstract

Purpose

This is a rare case of a post-traumatic rectus abdominis muscle tear in an adolescent female diagnosed by ultrasonography (US). Conservative management is also described.

Methods

A 14-year-old female presented to a chiropractic clinic with extreme pain and tenderness in the right lower quadrant (RLQ) after post-plyometric power kneel box jumps. Movement aggravated her pain and she demonstrated active abdominal guarding with RLQ palpation. Ultrasonography revealed a subacute Grade 2 right rectus abdominis muscle tear, without evidence of hyperemia or a hematoma. Following the diagnosis of a right rectus abdominis muscle tear, she was treated with spinal manipulation and a course of musculoskeletal rehabilitation directed at truncal stabilization.

Results

After treatment, the patient was able to return to play 5 week post-injury without any pain or discomfort. A follow-up US at 3 months provided evidence of muscle healing without complications.

Conclusion

This case demonstrates the diagnosis of a rare rectus abdominis muscle tear managed conservatively. To our knowledge, less than a dozen cases are reported using US in the evaluation and diagnosis of a rectus abdominis tear.

Keywords

Rectus abdominis tear Ultrasonography Spinal manipulation Muscle tear Rehabilitation 

Notes

Funding

No funding was received.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Megliola A, Eutropi F, Scorzelli A et al (2006) Ultrasound and magnetic resonance imaging in sports-related muscle injuries. Radiol Med 111(6):836–845CrossRefGoogle Scholar
  2. 2.
    Peetrons P (2002) Ultrasound of muscles. Eur Radiol 12(1):35–43CrossRefGoogle Scholar
  3. 3.
    Guermazi A, Roemer FW, Robinson P, Tol JL, Regatte RR, Crema MD (2017) Imaging of muscle injuries in sports medicine: sports imaging series. Radiology 285(3):1063CrossRefGoogle Scholar
  4. 4.
    Grassi A, Quaglia A, Canata GL, Zaffagnini S (2016) An update on the grading of muscle injuries: a narrative review from clinical to comprehensive systems. Joints 4(1):39–46CrossRefGoogle Scholar
  5. 5.
    Jarvinen TA, Jarvinen TL, Kaariainen M, Kalimo H, Jarvinen M (2005) Muscle injuries: biology and treatment. Am J Sports Med 33(5):745–764CrossRefGoogle Scholar
  6. 6.
    Minardi J, Shaver E, Monseau A, Pratt A, Layman SM (2015) Right lower quadrant pain in a young female: ultrasound diagnosis of rectus abdominis tear. J Emerg Med 49(5):623–626CrossRefGoogle Scholar
  7. 7.
    Connell D, Ali K, Javid M, Bell P, Batt M, Kemp S (2006) Sonography and MRI of rectus abdominis muscle strain in elite tennis players. AJR Am J Roentgenol 187(6):1457–1461CrossRefGoogle Scholar
  8. 8.
    Forney MC, Delzell PB (2018) Musculoskeletal ultrasonography basics. Cleve Clin J Med 85(4):283–300CrossRefGoogle Scholar
  9. 9.
    Hashimoto BE, Kramer DJ, Wiitala L (1999) Applications of musculoskeletal sonography. J Clin Ultrasound 27(6):293–318CrossRefGoogle Scholar
  10. 10.
    Pillen S, Boon A, Van Alfen N (2016) Muscle ultrasound. Handb Clin Neurol 136:843–853CrossRefGoogle Scholar
  11. 11.
    Chan O, Del Buono A, Best TM, Maffulli N (2012) Acute muscle strain injuries: a proposed new classification system. Knee Surg Sports Traumatol Arthrosc 20(11):2356–2362CrossRefGoogle Scholar
  12. 12.
    Draghi F, Zacchino M, Canepari M, Nucci P, Alessandrino F (2013) Muscle injuries: ultrasound evaluation in the acute phase. J Ultrasound 16(4):209–214CrossRefGoogle Scholar
  13. 13.
    Jarvinen TA, Jarvinen TL, Kaariainen M et al (2007) Muscle injuries: optimising recovery. Best Pract Res Clin Rheumatol 21(2):317–331CrossRefGoogle Scholar
  14. 14.
    Maffulli N, Del Buono A, Oliva F et al (2015) muscle injuries: a brief guide to classification and management. Transl Med UniSa 12:14–18PubMedGoogle Scholar
  15. 15.
    Lacroix VJ (2000) A complete approach to groin pain. Phys Sportsmed 28(1):66–86CrossRefGoogle Scholar
  16. 16.
    Tanizaki R, Takemura Y (2017) Anterior cutaneous nerve entrapment syndrome with pain present only during Carnett’s sign testing: a case report. BMC Res Notes 10(1):503CrossRefGoogle Scholar
  17. 17.
    Lee JC, Healy J (2004) Sonography of lower limb muscle injury. AJR Am J Roentgenol 182(2):341–351CrossRefGoogle Scholar
  18. 18.
    Jacobson JA, Khoury V, Brandon CJ (2015) Ultrasound of the groin: techniques, pathology, and pitfalls. AJR Am J Roentgenol 205(3):513–523CrossRefGoogle Scholar
  19. 19.
    Arend CF (2013) Static and dynamic sonography for diagnosis of abdominal wall hernias. J Ultrasound Med 32(7):1251–1259CrossRefGoogle Scholar
  20. 20.
    Kumbhare D, Shaw S, Ahmed S, Noseworthy MD (2018) Quantitative ultrasound of trapezius muscle involvement in myofascial pain: comparison of clinical and healthy population using texture analysis. J Ultrasound.  https://doi.org/10.1007/s40477-018-0330-5 CrossRefPubMedGoogle Scholar
  21. 21.
    Barbuto L, Di Serafino M, Della Vecchia N et al (2018) Pediatric musculoskeletal ultrasound: a pictorial essay. J Ultrasound 22(4):491–502CrossRefGoogle Scholar
  22. 22.
    Takebayashi S, Takasawa H, Banzai Y et al (1995) Sonographic findings in muscle strain injury: clinical and MR imaging correlation. J Ultrasound Med 14(12):899–905CrossRefGoogle Scholar
  23. 23.
    Cocco G, Ricci V, Boccatonda A, Iannetti G, Schiavone C (2018) Migration of calcium deposit over the biceps brachii muscle, a rare complication of calcific tendinopathy: ultrasound image and treatment. J Ultrasound 21(4):351–354CrossRefGoogle Scholar
  24. 24.
    Souza J, Gottfried C (2013) Muscle injury: review of experimental models. J Electromyogr Kinesiol 23(6):1253–1260CrossRefGoogle Scholar
  25. 25.
    Frank C, Kobesova A, Kolar P (2013) Dynamic neuromuscular stabilization and sports rehabilitation. Int J Sports Phys Ther. 8(1):62–73PubMedPubMedCentralGoogle Scholar
  26. 26.
    Baoge L, Van Den Steen E, Rimbaut S et al (2012) Treatment of skeletal muscle injury: a review. ISRN Orthop 2012:689012CrossRefGoogle Scholar

Copyright information

© Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB) 2019

Authors and Affiliations

  1. 1.Department of RadiologyLogan UniversityChesterfieldUSA
  2. 2.Winchester Sport and SpineTroyUSA

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