Delayed onset muscle soreness

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Delayed onset muscle soreness (DOMS) refers to the muscular pain and swelling that follows unaccustomed exertion.

Clinical presentation

Patients may have an ache in affected muscles with reduced strength .

Pathology

DOMS is thought to occur from reversible microstructural muscle injury that is followed by an inflammatory process and subsequent shifts of fluid and electrolytes. There is usually no permanent damage to muscle function.

Serology
  • serum CK levels are often elevated

Radiographic features

Ultrasound

Most commonly DOMS presents as :

  • diffuse, well-defined hyperechoic regions within muscle
  • increased muscle size
  • minimal hyperemia
MRI
  • T2/STIR: affected muscles are high signal and this may persist for months following resolution of symptoms

Differential diagnosis

For MRI appearances consider:

See also