Marc Regier, Presenter: Nothing to Disclose

Cyrus Behzadi, Abstract Co-Author: Nothing to Disclose

Frank Oliver Gerhard Henes MD, Abstract Co-Author: Nothing to Disclose

Chressen Catharina Remus MD, Abstract Co-Author: Nothing to Disclose

Gerhard B. Adam MD, Abstract Co-Author: Nothing to Disclose

Philip Catala-Lehnen, Abstract Co-Author: Nothing to Disclose

To determine the prognostic value of MRI for the estimation of the rehabilitation period after thigh muscle injury in professional soccer players and to evaluate imaging findings at return-to-play (RTP).

During three consecutive seasons 87 thigh muscle injuries were examined at 3T MRI in 47 players of the highest professional level. The predefined imaging protocol included coronal and transversal T2w STIR, T2w TSE, DWI and T1w TSE sequences. Identical scans were performed the day after the injury occured and on the day of RTP. All MRI data sets were independently read by two blinded radiologists and muscle injuries were graded applying Peetrons classification system (grade 0-3). Additionally, transversal area measurements of the muscle were performed and the percentage of the affected portion was recorded reading T2w and DWI images at the time of injury and RTP. The grade of muscle injury and the affected transversal muscle area were correlated to the duration of the rehabilitation period. Statistical analysis included Wilcoxon-matched-pairs and Chi-square test.

Muscle injuries were assigned grade 0 in 4.6% (4/87), grade 1 in 64.3% (56/87), grade 2 in 27.6% (24/87) and grade 3 in 3.4% (3/87). The mean duration of the rehabilitation correlated well with the severity of injury in all grades (grade 0, 6 days; grade 1, 12 days; grade 2, 20 days; grade 3, 46 days; p<0.001). The transversal area of signal abnormalties at time of injury showed a robust correlation with the time to RTP reading the T2w (p=0.02) and DWI (p=0.01) data. At RTP persistent signal abnormalties within the affected muscle were found in 75.8% (66/87). Six (6.9%) re-injuries were recorded within 30 days following RTP.

In professional soccer players, MRI based grading and transversal area measurements of thigh muscle injury strongly correlate with the duration of convalescence and can be used to estimate players time of abscence. Even at relief of symptoms and return to maximum physical exertion a decreasing though persistently elevated signal at fluid-sensitive T2w and DWI MRI can frequently be observed.

MRI can be referred to as a valuable tool in the prognostication of thigh muscle injuries in professional soccer players, however, normalisation of imaging findings is not mandatory for return to play.

Regier, M, Behzadi, C, Henes, F, Remus, C, Adam, G, Catala-Lehnen, P, Magnetic Resonance Imaging (MRI) of Muscle Strains of the Thigh in Professional Soccer players: Correlation of Imaging Findings with the Duration of Convalescence and Presentation at Return to Play.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14014101.html