Sonia Branci1, Kristian Thorborg2, Birthe Højlund Bech3, Mikael Boesen4, Michael Bachmann Nielsen3, Per Hölmich5. 1. Department of Orthopaedic Surgery, Sports Orthopaedic Research Center-Copenhagen, Arthroscopic Center Amager, Copenhagen University Hospital, Amager-Hvidovre, Denmark Department of Radiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. 2. Department of Orthopaedic Surgery, Sports Orthopaedic Research Center-Copenhagen, Arthroscopic Center Amager, Copenhagen University Hospital, Amager-Hvidovre, Denmark. 3. Department of Radiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. 4. Department of Radiology, Bispebjerg and Frederiksberg Hospital University of Copenhagen, Copenhagen, Denmark Parker Institute, Bispebjerg and Frederiksberg Hospital University of Copenhagen, Copenhagen, Denmark. 5. Department of Orthopaedic Surgery, Sports Orthopaedic Research Center-Copenhagen, Arthroscopic Center Amager, Copenhagen University Hospital, Amager-Hvidovre, Denmark Aspetar Sports Groin Pain Center, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
Abstract
BACKGROUND: Soccer players are commonly affected by long-standing adductor-related groin pain (ARGP), but the clinical significance of MRI findings in these athletes is largely unknown. Our aims were (1) to evaluate whether MRI findings are associated with long-standing ARGP in soccer players, (2) to assess MRI findings in asymptomatic soccer players and non-soccer playing controls. METHODS: This cross-sectional study included 28 male soccer players with long-standing ARGP, 17 male asymptomatic soccer players and 20 male asymptomatic non-soccer playing athletes of matching age and athletic exposure. Participants underwent identical standardised and reliable clinical examination, and MRI scans (3 T) of the pelvis performed by a blinded observer. Images were consensus rated by three blinded radiologists according to a standardised MRI evaluation protocol. The associations between clinical adductor-related findings and pathological MRI findings were investigated with χ(2) statistics and OR. RESULTS: Central disc protrusion (p=0.027) and higher grades of pubic bone marrow oedema (BMO; p=0.027) were significantly more present in symptomatic players than asymptomatic players. However, up to 71% of asymptomatic soccer players displayed different positive MRI findings, and asymptomatic soccer players had significantly higher odds (OR ranging from 6.3 to 13.3) for BMO, adductor tendinopathy and degenerative changes than non-soccer players. CONCLUSIONS: ARGP in soccer players was associated with central disc protrusion and higher grades of pubic BMO. Moreover, positive MRI findings were significantly more frequent in soccer players compared with non-soccer players irrespective of symptoms, suggesting that these MRI changes may be associated with soccer play itself rather than clinical symptoms. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
BACKGROUND: Soccer players are commonly affected by long-standing adductor-related groin pain (ARGP), but the clinical significance of MRI findings in these athletes is largely unknown. Our aims were (1) to evaluate whether MRI findings are associated with long-standing ARGP in soccer players, (2) to assess MRI findings in asymptomatic soccer players and non-soccer playing controls. METHODS: This cross-sectional study included 28 male soccer players with long-standing ARGP, 17 male asymptomatic soccer players and 20 male asymptomatic non-soccer playing athletes of matching age and athletic exposure. Participants underwent identical standardised and reliable clinical examination, and MRI scans (3 T) of the pelvis performed by a blinded observer. Images were consensus rated by three blinded radiologists according to a standardised MRI evaluation protocol. The associations between clinical adductor-related findings and pathological MRI findings were investigated with χ(2) statistics and OR. RESULTS: Central disc protrusion (p=0.027) and higher grades of pubic bone marrow oedema (BMO; p=0.027) were significantly more present in symptomatic players than asymptomatic players. However, up to 71% of asymptomatic soccer players displayed different positive MRI findings, and asymptomatic soccer players had significantly higher odds (OR ranging from 6.3 to 13.3) for BMO, adductor tendinopathy and degenerative changes than non-soccer players. CONCLUSIONS: ARGP in soccer players was associated with central disc protrusion and higher grades of pubic BMO. Moreover, positive MRI findings were significantly more frequent in soccer players compared with non-soccer players irrespective of symptoms, suggesting that these MRI changes may be associated with soccer play itself rather than clinical symptoms. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Authors: Andreas Serner; Frank W Roemer; Per Hölmich; Kristian Thorborg; Jingbo Niu; Adam Weir; Johannes L Tol; Ali Guermazi Journal: Eur Radiol Date: 2016-07-06 Impact factor: 5.315
Authors: Eamonn Delahunt; Kristian Thorborg; Karim M Khan; Philip Robinson; Per Hölmich; Adam Weir Journal: Br J Sports Med Date: 2015-06 Impact factor: 13.800
Authors: G N Bisciotti; P Volpi; R Zini; A Auci; A Aprato; A Belli; G Bellistri; P Benelli; S Bona; D Bonaiuti; G Carimati; G L Canata; G Cassaghi; S Cerulli; G Delle Rose; P Di Benedetto; F Di Marzo; F Di Pietto; L Felicioni; L Ferrario; A Foglia; M Galli; E Gervasi; L Gia; C Giammattei; A Guglielmi; A Marioni; B Moretti; R Niccolai; N Orgiani; A Pantalone; F Parra; A Quaglia; F Respizzi; L Ricciotti; M T Pereira Ruiz; A Russo; E Sebastiani; G Tancredi; F Tosi; Z Vuckovic Journal: BMJ Open Sport Exerc Med Date: 2016-11-29