Diagnostic Musculoskeletal Ultrasound in the Evaluation of the Rectus Abdominis

The rectus abdominis (RA) muscle is a key muscle in the anterior abdominal wall, contributing to motion of trunk flexion, assisting with stabilization of the pelvis, and maintaining intra-abdominal pressure. Its integrity is essential for posture, respiration, and functional movement, and it is frequently implicated in clinical conditions such as abdominal wall hernias, rectus diastasis, muscle strains, and postoperative complications. Accurate evaluation of the RA is therefore critical for both diagnostic and rehabilitative purposes. Musculoskeletal ultrasound (MSKUS) has emerged as a valuable imaging modality for assessing the structure and function of the RA muscle. Offering real-time, dynamic visualization without ionizing radiation, MSKUS enables clinicians and researchers to examine muscle morphology, thickness, echogenicity, and contractile behavior with high precision. Compared with other imaging modalities such as computed tomography or magnetic resonance imaging, MSKUS is more accessible, cost-effective, and well-suited for repeated assessments in both clinical and research settings. Recent advances in MSKUS have expanded its role in evaluating abdominal wall musculature, particularly in populations ranging from athletes and postoperative patients to postpartum women. By providing detailed, noninvasive insights into the RA muscle, MSKUS contributes to improved diagnosis, monitoring of rehabilitation progress, and the development of targeted interventions.