MRI findings in athletic groin pain: correlation of imaging with history and examination in symptomatic and asymptomatic athletes.

Ooi, MWX.; Marzetti, M.; Rowbotham, E.; Bertham, D.; Robinson, P.

MRI findings in athletic groin pain: correlation of imaging with history and examination in symptomatic and asymptomatic athletes.

All Authors

Ooi, MWX.

Marzetti, M.

Rowbotham, E.

Bertham, D.

Robinson, P.

LTHT Author

Ooi, Michelle Wei Xin
Marzetti, Matthew
Rowbotham, Emma
Rowbotham, Emma
Bertham, Dominic
Robinson, Philip

LTHT Department

Radiology
NIHR Leeds Biomedical Research Centre
Medical Physics & Engineering

Non Medic

Registered Medical Scientist - Magnetic Resonance

Publication Date

2025

Item Type

Evaluation Study
Journal Article

Abstract

OBJECTIVE: To determine differences in prevalence and diagnostic accuracy of MRI findings between asymptomatic athletes and athletes with longstanding groin pain. MATERIALS AND METHODS: One hundred twenty-three adult male athletes were approached with 85 consecutive athletes recruited. Group 1 (symptomatic, n = 34) athletes referred for longstanding groin pain (insidious onset, > 3 weeks duration). Group 2 (control, n = 51) athletes referred for injuries remote from the pelvis and no groin pain in the last 12 weeks. All referrers completed a clinical examination proforma documenting absence or presence of pelvis and hip abnormality. All patients completed the Copenhagen Hip and Groin Outcome Score (HAGOS) questionnaire and underwent a 3T MRI groin and hip protocol. MRIs were scored independently by two musculoskeletal radiologists blinded to clinical details. Statistical analysis was performed to evaluate associations between MRI findings, inter-reader reliability, clinical examination and HAGOS scores. RESULTS: Pubic body subchondral bone oedema, capsule/aponeurosis junction tear and soft tissue oedema were more prevalent in the symptomatic group (p = 0.0003, 0.0273 and 0.0005, respectively) and in athletes with clinical abnormality at symphysis pubis, adductor insertion, rectus abdominis, psoas and inguinal canal (p = 0.0002, 0.0459 and 0.00002, respectively). Pubic body and subchondral oedema and capsule/aponeurosis tear and oedema significantly correlated with lower (worse) HAGOS scores (p = 0.004, 0.00009, 0.0004 and 0.002, respectively). Inter-reader reliability was excellent, 0.87 (range 0.58-1). Symphyseal bone spurring, disc protrusion and labral tears were highly prevalent in both groups. CONCLUSION: Clinical assessment and MRI findings of pubic subchondral bone oedema and capsule/aponeurosis abnormality appear to be the strongest correlators with longstanding groin pain.