Cohen's MRI scoring system has limited value in predicting return to play

Area of Science:

• Sports Medicine
• Diagnostic Imaging
• Musculoskeletal Injuries

Background:

• Hamstring strains are common in male football (soccer) players.
• Predicting return to sport (RTS) duration after hamstring injury is clinically important.
• MRI scoring systems have been hypothesized to aid in predicting RTS.

Purpose of the Study:

• To prospectively evaluate the predictive value of the Cohen MRI scoring system for RTS in male soccer players.
• To determine if MRI findings correlate with the time taken to return to sport after acute hamstring injury.

Main Methods:

• A prospective case series (Level of Evidence: IV) of 139 male football players with acute hamstring injuries.
• Standardized clinical and MRI examinations were performed within 5 days of injury.
• Players followed a standardized physiotherapy regimen, and RTS was documented and statistically evaluated against MRI scores.

Main Results:

• One hundred and ten MRI-positive hamstring injuries were analyzed, with RTS durations ranging from 1 to 66 days.
• The total Cohen's MRI score explained only about 4% of the variance in RTS duration.
• Players with an MRI score of 10 or higher took significantly longer (average 9.8 days) to return to sport compared to those with scores below 10 (p < 0.01).

Conclusions:

• The Cohen MRI scoring system, as utilized in this study, did not provide a clinically useful prognosis for RTS in male soccer players.
• The findings suggest challenges in accurately determining RTS duration from a single-time point imaging assessment.