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Objective To explore the application value of musculoskeletal ultrasound (MSUS) in grading acute gastrocnemius muscle injuries. Methods A retrospective analysis was conducted on ultrasound images of 291 patients who presented with sudden calf pain and suspected acute gastrocnemius muscle injury in the General Hospital of Central Theater Command from March 2019 to July 2024. The images were independently reviewed and assessed by three ultrasound doctors with different qualifications to determine the presence and grade of gastrocnemius muscle injury. The consistency of grading results among three doctors was compared. The diagnostic results of three doctors were summarized. Then, the diagnostic results of 29 patients who underwent routine MRI scans were compared with those of MSUS, and the agreement between the two imaging modalities was assessed using the Kappa test. Results Among the 291 patients, 171 cases (58.8%) were diagnosed with gastrocnemius muscle injury, including 55 cases (32.2%) with grade Ⅰ, 109 cases (63.7%) with grade Ⅱ, and 7 cases (4.1%) with grade Ⅲ. There were 159 cases (93.0%) of unilateral medial head injury, 10 cases (5.8%) of unilateral lateral head injury, and 2 cases (1.2%) of bilateral medial and lateral head injury. Compared with patients without gastrocnemius muscle injury, patients with gastrocnemius muscle injury were older (P<0.05), with no significant difference in gender and laterality (P>0.05). No significant differences in baseline characteristics were found among patients with different grades of injury (P>0.05). The three doctors diagnosed 173 (59.5%), 171 (58.8%), and 171 (58.8%) cases of injury, respectively, with an inter-class correlation coefficient (ICC) of 0.947 (P<0.001). Among 29 patients who underwent MRI, the diagnostic agreement between MRI and ultrasound for grade Ⅰ, Ⅱ and Ⅲ injury was 8 (27.6%), 18 (62.1%) and 3 (10.3%) for MRI; and 9 (31.0%), 17 (58.6%) and 3 (10.3%) for MSUS, respectively, with a Kappa value of 0.808 (P<0.001). Conclusions MSUS is effective for assessing the grade of acute gastrocnemius muscle injury, and shows high diagnostic consistency among doctors with different qualifications. It is recommended as the preferred method for diagnosing gastrocnemius muscle injury.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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