Imaging findings of sports-related acute core muscle injuries

Sports-related core muscle injuries are a common cause of acute and chronic groin and lower abdominal pain in athletes, particularly in activities involving cutting, kicking, and rotational movements. These injuries encompass a broad spectrum of musculoskeletal pathology affecting the abdominal wall, pelvis, and proximal thigh, frequently with overlapping clinical presentations that complicate diagnosis and management. Variability in terminology and injury classification further contributes to diagnostic complexity, underscoring the importance of precise and consistent imaging characterization. Accurate imaging evaluation plays a central role in defining the location, extent, and pattern of injury, informing clinical decision-making and supporting return-to-play planning. This article reviews the imaging features of sports-related core muscle injuries with emphasis on relevant anatomy, biomechanics, and a structured, anatomy-based imaging approach. Management considerations relevant to each injury pattern are discussed within the corresponding sections. Specific injury patterns discussed include side strains, hip pointers, rectus abdominis strains, and acute adductor-related core muscle injuries. By integrating detailed anatomic knowledge with injury mechanisms and characteristic imaging appearances, this review provides a practical framework to support consistent, clinically meaningful interpretation of core muscle injuries and effective communication with referring clinicians involved in the care of athletes.