Role of ultrasound and magnetic resonance imaging in the prognosis and classification of muscle injuries in professional football players: correlation between imaging and return to sport time

Purpose: To study distractive muscle injuries applying US and MRI specific classifications and to find if any correlation exists between the results and the return to sport (RTS) time. The second purpose is to evaluate which classification has the best prognostic value and if the lesions extension correlates with the RTS time. Methods: A total of 26 male, professional soccer players (age 21.3 ± 5.6), diagnosed with traumatic muscle injury of the lower limbs, received ultrasound and MRI evaluation within 2 days from the trauma. Concordance between US and MRI findings was investigated. The relationships between MRI and US based injury grading scales and RTS time were evaluated. Correlation between injuries’ longitudinal extension and RTS time was also investigated. Results: The correlation between US and MRI measurements returned a Spearman value of rs = 0.61 (p =.001). Peetrons and Mueller-Wohlfahrt grading scales correlations with RTS time were r = 0.43 (p =.02) and r = 0.83 (p = <.001). The lesion’s extension correlation with RTS time was r = 0.63 (p <.001). The correlation between the site of the lesion and its location with the RTS time were rs = 0.2 and rs = 0.25. Conclusions: Both US and MRI can be used as prognostic indicators along with the Peetrons (US) and the Mueller-Wohlfahrt (MRI) classifications. MRI is more precise and generates more reproducible results. The lesion craniocaudal extension must be considered as a prognostic indicator, while the injury location inside the muscle or along its major axis has doubtful significance.