MLB Injury Update: Key Players Out With Injuries
Fantasy Baseball Injury Report: Medical Imaging Differences

Fantasy Baseball Injury Report: Medical Imaging Differences

This article is part of our Fantasy Baseball Injury Report series.

Rhys Hoskins

The Brewers veteran will miss time after suffering a thumb injury while applying a tag over the weekend. Initial medical images ruled out a fracture, but a subsequent set of images found a sprain.

Hoskins serves as a good case to remind everyone the differences in medical imaging. X-rays are the go-to images following an acute injury. They are cheap and fast with many MLB stadiums housing on-site X-ray equipment. X-rays are most commonly used to examine bone tissue, visible through two-dimensional images obtained by using radiation. Because the produced radiograph (image) is two-dimensional, certain body parts require multiple images to be taken at various angles or positions. Unfortunately, plain radiographs can be misleading. Occasionally, a tiny fracture may not be visible on the initial films taken. Only after healing has begun will these breaks show up on a subsequent X-ray. Think Yordan Alvarez (more on him later).

CT scans also use radiation to produce images that are more detailed than standard X-ray. The images are obtained as the patient enters a gantry in which the X-ray device rotates around the injured area. The result is a 3D-image created by stacking the multiple images obtained.  

Magnetic resonance imaging (MRI) can be even more complex and accurate, and utilizes magnets as opposed to radiation. Like a CT scan, an MRI is created using layered cross-sectional scans of the area of concern. The image is also three-dimensional and can be used to view soft tissue structures like muscle, tendon and

Rhys Hoskins

The Brewers veteran will miss time after suffering a thumb injury while applying a tag over the weekend. Initial medical images ruled out a fracture, but a subsequent set of images found a sprain.

Hoskins serves as a good case to remind everyone the differences in medical imaging. X-rays are the go-to images following an acute injury. They are cheap and fast with many MLB stadiums housing on-site X-ray equipment. X-rays are most commonly used to examine bone tissue, visible through two-dimensional images obtained by using radiation. Because the produced radiograph (image) is two-dimensional, certain body parts require multiple images to be taken at various angles or positions. Unfortunately, plain radiographs can be misleading. Occasionally, a tiny fracture may not be visible on the initial films taken. Only after healing has begun will these breaks show up on a subsequent X-ray. Think Yordan Alvarez (more on him later).

CT scans also use radiation to produce images that are more detailed than standard X-ray. The images are obtained as the patient enters a gantry in which the X-ray device rotates around the injured area. The result is a 3D-image created by stacking the multiple images obtained.  

Magnetic resonance imaging (MRI) can be even more complex and accurate, and utilizes magnets as opposed to radiation. Like a CT scan, an MRI is created using layered cross-sectional scans of the area of concern. The image is also three-dimensional and can be used to view soft tissue structures like muscle, tendon and ligaments.

For Hoskins, a thumb fracture was ruled out, though an MRI uncovered a Grade 2 or partial tear of one of the stabilizing ligaments of his thumb. While surgery may not be necessary, ample time will be needed to allow the ligament to adequately heal. A return in mid-August may be a best-case scenario for the first baseman.

Max Muncy

While most fear the worst when a player is scheduled for an MRI, the images do often reveal good news. Consider Muncy, who was injured Wednesday in a collision with White Sox outfielder Michael Taylor. Muncy's left knee absorbed the brunt of the impact as a valgus stress was applied to the joint. This mechanism of injury often results in a sprained medial collateral ligament (MCL) or, even worse, an anterior cruciate ligament (ACL) tear. Fortunately, the MRI showed the ligaments remain intact, and Muncy's official diagnosis is a bone contusion. Bone contusions, especially those in the knee, still need substantial time to heal, as the body's natural healing response treats the issue just as it would a fracture. The Dodgers expect Muncy to miss at least six weeks, but that's a lot better timeline than it could have been if ligaments were involved. Tommy Edman was expected to see an increase in playing time with Muncy sidelined, but he was unable to play Sunday with an undisclosed pinkie toe issue.

Check Swings

Yordan Alvarez: The Houston outfielder suffered a setback in his injured hand just when it appeared he was about to return to action. Out since May 3 with a fracture in his fourth metacarpal, Alvarez experienced renewed discomfort in the area after taking swings early last week. The discomfort has since been linked to lingering inflammation in the area that was treated with multiple injections. The injections were likely anti-inflammatories but will prevent him from resuming baseball activities. He remains without a timeline and an absence through the All-Star break should be expected. His placement on the 60-day IL was purely procedural, as he has already eclipsed that mark.

Kerry Carpenter: The Tigers placed Capenter on the 10-day IL with a strained right hamstring. The strain is considered mild with a possible return right before the All-Star break. However, given the fickle nature of hamstring strains, look for Detroit to play things cautiously and hold him out until after the break.

Yu DarvishThe Padres will welcome the right-hander back into the mix Monday. Darvish has not pitched this season as he worked his way back from right elbow inflammation that was delayed by a setback during the recovery process. Darvish has proven he can pitch effectively coming off injury, but scale back your initial expectations.

Andres Gimenez: The surging Blue Jays will be without Gimenez for the foreseeable future after he suffered a sprained left ankle. Manager John Schneider said the 26-year-old second baseman will be placed in a protective walking boot for the next five-to-seven days before being re-evaluated. The boot's primary purpose is to allow Gimenez to walk around without the assistance of crutches, but he will still be able to rehab and receive treatment over the next week. Based on Schenider's message, it seems likely this absence will extend beyond the minimum 10 days.

Teoscar Hernandez: Medical imaging will be crucial in determining if Hernandez will avoid the injured list or remain day-to-day. The Dodgers outfielder did not play Sunday after fouling a ball off his left foot. He is slated to undergo testing soon, perhaps as early as Monday morning. Look for more details to emerge about the severity of his ailment.

Chris Sale: The Braves proactively placed Sale on the 60-day IL as he recovers from multiple rib fractures. The move is disappointing and ensures he cannot return until late August. However, it does remove some of the guess work about a possible target date. Look for him to resume throwing as the ribs heal, kick-starting the return to play process.

Clarke Schmidt: The Yankees right-hander is expected to undergo Tommy John surgery on his injured elbow, ending his season. The timing of the injury will also impact his 2026 campaign. Sadly, Schmidt is familiar with the rehab process, having undergone Tommy John in 2017. The setback is just the latest blow to a New York rotation without Gerrit Cole (Tommy John), Luis Gil (latissimus dorsi strain) and Ryan Yarbrough (oblique strain).

Kodai Senga: Senga has completed his rehab assignment with Double-A Binghamton and is expected to return to the Mets rotation later this week. The right-hander has missed almost a month with a strained right hamstring. This also appears to be a case where the scheduled All-Star break could impact his initial workload in hopes of him entering the second half at full strength. Don't be surprised if New York keeps him on a short leash in his return.

Stay up to date on who is in and who is out with RotoWire's MLB Injury Report!

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ABOUT THE AUTHOR
Jeff Stotts
Jeff Stotts works as a Certified Athletic Trainer (MAT, ATC, PES, CES). He won the 2011 Best Fantasy Football Article in Print from the Fantasy Sports Trade Association.
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