Coronal and axial T2 fat sat images of the lower limbs. This, taken from a guy who ran a marathon without adequate training.


The images reveal oedema in the gastrocnemius muscles bilaterally, with fluid in the gastrocsoleus myotendinous junction. This is a grade 2/3 myotendinous junction tear. You can see this in tennis players, but bilateral changes are somewhat less common.


Grading of myotendinous junction injuries is as follows:
Grade 1- oedema, without disruption.
Grade 2- partial tear of the myotendinous junction with oedema/haemorrhage
Grade 3- complete tear with oedema and haemorrhage