3.0-Tesla MRI Observation at Return to Play After Hamstring Injuries

Area of Science:

• Sports Medicine
• Radiology
• Musculoskeletal Imaging

Background:

• Hamstring injuries are common in athletes, impacting return to play (RTP) decisions.
• 3.0-Tesla (3T) magnetic resonance imaging (MRI) is a key tool for evaluating hamstring injuries.
• Understanding MRI findings at RTP is crucial for athlete management.

Purpose of the Study:

• To characterize 3T MRI findings in athletes who have clinically recovered from hamstring injuries and are cleared for RTP.
• To identify common abnormalities present at the time of RTP.

Main Methods:

• Prospective observational study including 58 amateur and professional athletes cleared for RTP after hamstring injury.
• 3T MRI scans were performed at baseline (within 7 days of injury) and at RTP (within 10 days of RTP).
• Evaluated injury location, grade (modified Peetrons and BAMIC), signal intensity, tendon disruption, and thickness; reinjuries were tracked.

Main Results:

• At RTP, 95% of athletes showed intramuscular edema and 76% showed fibrosis on 3T MRI.
• Injury grades generally reduced from initial injury to RTP.
• Intramuscular tendon abnormalities (disruption, waviness, thickening) were present in 38%, 26%, and 62% of athletes, respectively.
• Only 5% of athletes had completely normal MRI findings at RTP; 5% experienced reinjury within one year.

Conclusions:

• 3T MRI reveals persistent abnormalities like edema, fibrosis, and tendon issues in most athletes cleared for RTP after hamstring injury.
• Complete MRI normalization should not be anticipated for RTP decisions.
• The association between these persistent MRI findings and reinjury risk requires further investigation in larger studies.