The Sonographic Muscle Injury Classification in Soccer: proposal for an ultrasound-based muscle injury classification

To propose a novel ultrasound-based classification system for muscle injuries in soccer players, termed the Sonographic Muscle Injury Classification in Soccer (SOMICS), and to evaluate its association, ordinal consistency, and agreement with the British Athletics Muscle Injury Classification (BAMIC).

This was a cross-sectional observational study including 51 adolescent male soccer players (11-19 years of age) with suspected acute myotendinous injuries. All athletes underwent ultrasound and magnetic resonance imaging (MRI) within 24 h after injury. Four experienced radiologists, working independently, reviewed the images.

Interobserver agreement was substantial for ultrasound (κ = 0.65) and MRI (κ = 0.70). A strong ordinal correlation was observed between SOMICS and BAMIC categories (ρ = 0.80; p < 0.001), with a statistically significant association (χ² = 52.53; p < 0.001).

The SOMICS demonstrated significant association, ordinal consistency, and substantial agreement with the BAMIC for severity stratification of muscle injuries. Although not intended to replace MRI-based classifications for prognostic decision-making, the SOMICS provides a structured, reproducible ultrasound-based approach that may be useful in clinical settings where MRI is not readily available or as a first-line imaging tool.