Semi-quantitative magnetic resonance imaging scoring of the knee detects previous injuries in professional soccer players

Purpose The medical examination (medical) is an important procedure in professional soccer since it has high economic relevance. In addition to clinical tests, magnetic resonance imaging (MRI) is used to assess joint health. In the present study, the reliability of semiquantitative knee MRI during the medical in professional soccer was tested, and its relationship with clinical data and days missed due to knee injury was observed. Methods In this cross-sectional study, between 2012 and 2019, 69 newly assigned players (age 18-35 years) from a professional soccer club underwent MRI (3.0 T) of both knee joints during their medical. Reported knee injuries and previously missed days due to injury were obtained from player anamnesis and the transfermarkt.com database. Based on the established Whole-Organ Magnetic Resonance Imaging Score (WORMS), two independent radiologists graded the MRI results. Further evaluation was based on the mean score of both knees. Results The mean WORMS for all subjects was 13.9 (median 10.5, range 0-61). Players with previous injuries had significantly higher scores than players without reported injuries (22.1 +/- 17.7 vs. 8.9 +/- 4.4, p < 0.002). Three outliers (previously undetected injuries) in the group of players without reported injuries were observed (6.7%). The WORMS was significantly correlated with a prior knee injury (r: 0.424, p < 0.0001) and days missed due to injury (r: 0.489, p < 0.001). Age was correlated with the WORMS (r: 0.386, p < 0.001). In a linear regression model, prior injury was the only significant predictor of a high WORMS (p = 0.001). The WORMS was a significant predictor of days missed due to injury (p < 0.0002) and prior injury (sensitivity: 78%, specificity: 91%, p = 0.006). The intraclass correlation coefficient was excellent (0.89). Conclusion Semiquantitative knee MRI for WORMS determination during the soccer medical is a robust and reliable method. Prior injury, even in players without documented trauma, was detected by the WORMS, and previously missed days due to injury were correlated with the semiquantitative MR knee score.

Automated summary

This study examined the reliability of semiquantitative knee MRI during the medical examination of professional soccer players, and its correlation with clinical data and missed days due to knee injury. The results showed that semiquantitative knee MRI is a robust method that can detect previous injuries and is correlated with days missed due to injury.