MRI Features of Acute Muscle Injuries in Professional Soccer Players: A Systematic Review of Prognostic Associations With Return to Play.

Background: In professional soccer players, muscle injuries are a primary cause of loss of time from competition and have high recurrence rates, thus posing management challenges. MRI is widely used for injury grading and prognosis, yet associations of MRI findings with return-to-play (RTP) timelines have been inconsistent. Objective: To evaluate prognostic associations with RTP duration of MRI features of acute muscle injuries in professional soccer players. Evidence Acquisition: A systematic review of the PubMed and Scopus databases was conducted from January 2024 to February 2025 for studies evaluating an MRI classification system for acute muscle injuries in professional soccer players and provided quantifiable RTP outcome. Extracted information was summarized through narrative synthesis, organized according to muscle group. Evidence Synthesis: The analysis included 12 studies, which evaluated a total of 961 acute muscle injuries in professional soccer players, all of whom were male. In eight studies of hamstring injuries, tendon involvement (particularly of the biceps femoris free tendon) and musculotendinous junction involvement were key findings for predicting prolonged RTP; edema had poor predictive utility. In addition, injury grades based on two different advanced MRI classification systems showed weak and moderate prognostic associations with MTP. In four studies of quadriceps injury, distal aponeurosis involvement and associated hematoma were key findings for predicting prolonged RTP beyond structural grades alone. In two studies of adductor injuries, intratendinous location, large muscle gap, and proximal injury site were key findings for predicting prolonged RTP. In one study of hip external rotator injuries, such injuries were generally mild, exhibiting a low structural grade on MRI and being associated with favorable prognosis (i.e., prompt RTP). In two studies of calf injuries, injury grade and extent of edema were key findings for predicting prolonged RTP. However, most reinjuries occurred within 2 months of RTP, commonly following low-grade injuries. Conclusion: The findings highlight the role of MRI in prognostic assessments across muscle groups in professional soccer athletes with acute muscle injury. Clinical Impact: MRI is an important, yet not standalone, component of the RTP decision-making process. Imaging, clinical, and functional criteria should be combined to inform RTP decisions.

• Publication year

  2025

• Venue

  AJR. American journal of roentgenology

• Publication date

  2025-11-12

• Fields of study

  Medicine

• Identifiers
  DOI 10.2214/AJR.25.33710PMID 41222245
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

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