How Should We Report Sports Muscle Injuries? A Seven-Step Clinically Relevant Checklist

Abstract Accurate interpretation of muscle injuries requires radiologists trained in anatomy, biomechanics, and clinical context, capable of recognizing their imaging characteristics. Despite advances in imaging techniques, guidance on structured reporting remains limited. Given the growing interest in assessing tissue regeneration, a critical factor in image interpretation and reporting is knowing the time elapsed since injury. We introduce the novel concept of the injury-to-imaging interval to distinguish acute injury from healing-related changes. This article presents a seven-step framework organized into three zones: (1) preparation zone (basic knowledge, clinical context, technical quality), (2) image evaluation zone (systematic review), and (3) report elaboration zone (descriptive report, classification, prognosis, and return-to-play guidance). Five clinical cases illustrate different locations, sports, and stages of healing using ultrasound and magnetic resonance imaging. The guide emphasizes optimization, pattern recognition, and clear communication of imaging findings that influence clinical decisions. Although severity classifications are increasingly muscle specific, detailed descriptive reporting remains essential for clinicians to apply the relevant system.