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

Muhammad Ikhwan Zein1,2,3, Gustaaf Reurink1,2,4,5,6, Jozef J M Suskens1,2

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Even after clinical recovery and return to play (RTP), most athletes show hamstring abnormalities on 3.0-Tesla MRI, including edema and fibrosis. Complete MRI normalization is not expected before RTP decisions.

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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.