Abstract
ObjectiveThis study aims to describe the prevalence, anatomy and morphology of ERSA (exercise-related signal abnormality) lesions, a previously undescribed pattern of muscle signal changes on MRI in professional soccer players with suspected acute thigh muscle injury.MethodsA multicenter retrospective review was performed of 287 MRIs of professional soccer players referred for suspected acute thigh injury from August 2017 to February 2020. MR images were reviewed for muscle signal abnormalities corresponding to a peritendinous ovoid region or a subfascial ring of faint increased signal on fluid-sensitive MR images. Imaging features including anatomical site, morphology, and craniocaudal length were recorded. Concomitant acute muscle injury was graded in accordance with the British Athletics Muscle Injury Classification (BAMIC).ResultsERSA lesions comprising a peritendinous ovoid region, a subfascial ring, or both, were identified in 40 muscles across 31/287 studies (10.8%). These lesions had a mean length of 15.8 cm and were predominantly located in the proximal or mid-portions of muscles. Affected muscles were rectus femoris (n = 22), adductor longus (n = 11), semitendinosus (n = 6) and biceps femoris (n = 1). 21/31 studies (67.7%) had a BAMIC grade 1–4 injury in a separate muscle, which were largely (81%) in a separate anatomic compartment or contralateral.ConclusionERSA lesions were evident on MRI in 10.8% of our cohort of professional soccer players referred for suspected acute thigh muscle injury. Characteristic morphology and the longitudinal length (mean 15.8 cm) distinguish ERSA lesions from recognized patterns of acute muscle injury.
Highlights
Muscle injuries are a common occurrence in sports at professional and amateur levels, frequencies of muscle injury vary between sports [1,2,3,4,5]
This study aims to describe the MRI appearances of these muscle signal changes in a cohort of professional soccer players who were imaged with a suspected acute thigh muscle injury, and to investigate the frequency and anatomical locations of these findings
A search was performed through the database for consecutive MRI studies of professional soccer players referred for suspected acute thigh muscle injury over a 30-month period from August 1, 2017 to February 1, 2020
Summary
Muscle injuries are a common occurrence in sports at professional and amateur levels, frequencies of muscle injury vary between sports [1,2,3,4,5]. Muscle injuries account for between 15 and 40% of all sports injuries in international championships, and most commonly involve the lower limb [4, 5]. Muscle injuries are an important cause of time lost to both training and play, accounting for a quarter of injury related absences in professional soccer [6]. The BAMIC classification system, in particular, has gained widespread use in professional sport over the past few years. It describes the MRI features of different grades (0–4)
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