📌 When Elbow Edema Isn’t a Tear — MRI Clues to Delayed onset muscle soreness

https://youtu.be/LsSVBuJ9MV8

 

https://youtube.com/shorts/aqm32avcGcA

 

Radiologic Essentials

1. Start With the Pattern
• Fluid-sensitive sequences show diffuse or patchy high signal
• Typically involves multiple muscles within a functional group
• This distribution immediately argues against a focal traumatic tear

2. Architecture Is the Key Anchor
• Fascicular architecture remains intact
• No macroscopic fiber disruption, retraction, or large hematoma
• Muscle bulk may be mildly increased but remains organized

3. Location Helps Exclude Strain
• Signal abnormality is not MTJ-centered
• More generalized involvement of the muscle belly
• Unlike Grade 1 strain, no feathery MTJ-tracking edema

4. Don’t Ignore the Fascia
• Deep fascial edema is commonly present
• Fascia has high nociceptor density and acts as a major pain generator
• Explains pain that appears disproportionate to structural findings

5. Expect MRI–Clinical Dissociation
• STIR/T2 hyperintensity may persist weeks to months
• Imaging abnormalities often outlast symptom resolution
• Persistent edema does not equal ongoing injury

Radiologic Take-Home Message

Diffuse, reversible muscle ± fascial edema
with preserved internal architecture
→ favors Delayed Onset Muscle Soreness (DOMS)
→ a functional muscle disorder, not a structural tear

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#SportsMRI #DOMS #MuscleEdema #ElbowMRI #MSKRadiology
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