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DOS Kongressen 2016 ·
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Reliability of MRI assessment of acute
musculotendinous groin injuries in athletes
Andreas Serner, Frank Roemer, Per Hölmich, Kristian Thorborg, Jingbo Niu, Adam
Weir, Johannes L Tol, Ali Guermazi
Sports Groin Pain Center, Aspetar Orthopaedic and Sports Medicine Hospital, Doha,
Qatar; Department of Radiology, University of Erlangen-Nuremberg, Erlangen,
Germany; Sports Orthopaedic Research Center–Copenhagen (SORC-C), Department
of Orthopedic Surgery , Copenhagen University Hospital, Amager-Hvidovre, Denmark;
SportsOrthopaedicResearchCenter–Copenhagen (SORC-C), Department ofOrthopedic
Surgery , Copenhagen University Hospital, Amager-Hvidovre, Denmark; Clinical
Epidemiology and Training Unit, Department of Medicine, Boston University School of
Medicine, Boston, MA, USA; Sports Groin Pain Center, Aspetar Orthopaedic and Sports
Medicine Hospital, Doha, Qatar; Sports Groin Pain Center, Aspetar Orthopaedic and
Sports Medicine Hospital, Doha, Qatar; Quantitative Imaging Center (QIC), Department
of Radiology, Boston University School of Medicine, Boston, MA, USA
Background:
Groin injuries are common in sports medicine as they frequently occur in
high intensity team sports, such as football, where they are considered the second most
frequent injury location. Most published literature on groin pain in athletes focuses on
long-standing symptoms. An assessment system for acute groin injuries is still lacking.
Purpose / Aim of Study:
To describe a multi-dimensional MRI assessment approach
with a focus on acute musculotendinous groin injuries, and to evaluate scoring reproduc-
ibility.
Materials and Methods:
Male athletes who participated in competitive sports and
presented within 7 days of an acute onset of sports-related groin pain were included.
All athletes underwent MRI (1.5 T) according to a standardized groin-centred protocol.
From several calibration sessions, a system was developed assessing grade, location and
extent of muscle strains, peri-lesional hematoma, as well as other non-acute findings
commonly associated with long-standing groin pain. Kappa ( ) statistics and intraclass
correlation coefficients (ICCs) were used to describe intra- and inter-rater reproduc-
ibility.
Findings / Results:
75 athletes (mean age 26.6 ± 4.4 years) were included in the
analyses, and 85 different acute lesions were observed. Adductor longus lesions were
most common (42.7%) followed by rectus femoris lesions (16.3%). Kappa values ranged
between 0.70 and 1.00 for almost all categorical features for acute lesions, with almost
perfect intra- and inter-rater agreement ( =0.89-1.00) for presence, number, location
and grading of lesions. ICCs ranged between 0.77 and 1.00 for continuous measures of
acute lesion extent.
Conclusions:
A standardized MRI assessment approach of acute groin injuries was de-
scribed and showed good intra- and inter-rater reproducibility.
No conflicts of interest reported
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