Musculoskeletal Ultrasound and Protein-Based Hydrogels: Novel Approaches for the Diagnosis and Treatment of Sports Injuries

Sports-related injuries involving muscle, tendon, cartilage, ligament, and bone remain challenging because of their heterogeneous mechanisms, high functional demands, and need for timely diagnosis, targeted repair, and rehabilitation monitoring. Musculoskeletal ultrasound (MSKUS) provides real-time, portable, radiation-free, and repeatable evaluation of injured tissues, including lesion location, structural continuity, vascular response, stiffness changes, and healing progression. Protein-based hydrogels, owing to their biocompatibility, tunable mechanics, extracellular matrix-like microenvironments, and capacity for localized bioactive delivery, offer promising platforms for tissue repair and functional recovery. This review summarizes major sports injuries, discusses the diagnostic and monitoring value of MSKUS, and analyzes protein-based hydrogels according to tissue-specific repair requirements. Particular attention is given to the connection between imaging assessment and hydrogel therapy, including ultrasound-guided delivery, lesion localization, post-treatment monitoring of hydrogel retention or degradation, and evaluation of therapeutic response. By linking MSKUS-based lesion assessment with hydrogel selection, image-guided delivery, post-intervention monitoring, and rehabilitation-oriented decision-making, this review outlines a coordinated framework for precise diagnosis and localized biomaterial-assisted repair in sports injury management.