MRI findings in soccer players with long-standing adductor-related groin pain and asymptomatic controls

TY - JOUR

T1 - MRI findings in soccer players with long-standing adductor-related groin pain and asymptomatic controls

AU - Branci, Sonia

AU - Thorborg, Kristian

AU - Bech, Birthe Højlund

AU - Boesen, Mikael

AU - Nielsen, Michael Bachmann

AU - Hölmich, Per

N1 - 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.

PY - 2015/5/1

Y1 - 2015/5/1

N2 - 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 X2 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 nonsoccer players irrespective of symptoms, suggesting that these MRI changes may be associated with soccer play itself rather than clinical symptoms.

AB - 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 X2 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 nonsoccer players irrespective of symptoms, suggesting that these MRI changes may be associated with soccer play itself rather than clinical symptoms.

KW - Abdominal Pain

KW - Adolescent

KW - Adult

KW - Bone Marrow Diseases

KW - Case-Control Studies

KW - Chronic Pain

KW - Cross-Sectional Studies

KW - Edema

KW - Groin

KW - Humans

KW - Intervertebral Disc Displacement

KW - Magnetic Resonance Imaging

KW - Male

KW - Soccer

KW - Tendinopathy

KW - Young Adult

U2 - 10.1136/bjsports-2014-093710

DO - 10.1136/bjsports-2014-093710

M3 - Journal article

C2 - 25512059

SN - 0306-3674

VL - 49

SP - 681

EP - 691

JO - British Journal of Sports Medicine

JF - British Journal of Sports Medicine

IS - 10

ER -