SPORTS INJURY AFTER A LANDING JUMP – WHEN MRI “DECODES” HIP PAIN

Mr. N.C.D., a 38-year-old male, is a physically fit recreational athlete who exercises regularly. During an attempt to jump down from a height of approximately 2 meters, he landed awkwardly on his left leg and immediately experienced a sudden, sharp pain in the left hip region.

The pain was not localized to a single point but radiated along the medial aspect of the left thigh, resulting in difficulty with ambulation and hip adduction movements. Concerned about the possibility of a fracture or ligament rupture, he presented to the clinic for evaluation and was referred for MRI of the left hip and thigh.

MRI FINDINGS

Magnetic Resonance Imaging (MRI) provided detailed visualization of deep soft-tissue structures that are difficult to fully assess with radiography or ultrasound:

• Location of injury: Diffuse edema and increased signal intensity were noted in the left adductor muscle group, including the pectineus, adductor brevis, and adductor longus muscles.
• Characteristics: The injury extended between muscle fiber bundles and along the fascial planes, with predominant involvement at the musculotendinous junction—the biomechanically weakest transition zone between muscle and tendon.
• Key findings: There was no evidence of complete fiber discontinuity with tendon retraction, no large intramuscular hematoma, and no avulsion injury at the tendon insertion or associated bony injury of the pelvis.

Conclusion

MRI findings are consistent with a Grade II muscle strain of the left thigh adductor muscle complex, without complete rupture.

CLINICAL ANALYSIS

In sports-related injuries—particularly during explosive movements such as jumping—the adductor muscle group is highly susceptible to acute overstretching injuries. Based on clinical examination alone, it is often challenging to reliably distinguish between:

• Mild muscle strain
• Partial muscle tear
• Complete muscle or tendon rupture / avulsion injury (which may require surgical intervention)

In this case, MRI confirmation of a Grade II injury (partial tearing of muscle fibers with preserved overall structural integrity) was crucial for determining the appropriate management strategy.

THE VALUE OF MRI IN SPORTS INJURIES

This case clearly demonstrates the indispensable role of MRI in musculoskeletal sports injuries:

• Precise anatomical localization: MRI allows visualization “through the skin” to accurately identify the specific muscles or ligaments involved—in this case, the adductor muscle complex.
• Severity assessment: Enables reliable classification of muscle injuries into Grade I, II, or III, which directly influences treatment decisions.

Treatment guidance:

• Grade III injuries (complete rupture or avulsion): Surgical repair may be indicated.
• Grade II injury, as in this patient: Orthopedic clinicians can confidently pursue conservative management (rest, immobilization, physical therapy, and pharmacologic treatment) without concern for missed surgical pathology.

Final Remarks

Sports injuries are often unavoidable; however, appropriate diagnostic evaluation determines the quality and speed of recovery.

In cases of acute pain following trauma or intense physical activity—particularly involving the hip and thigh—early MRI provides clinicians with an accurate “injury map.” This prevents inappropriate treatment (such as premature return to activity leading to complete rupture) and facilitates a safer, faster return to sport and daily function.