2017 ISAKOS Biennial Congress ePoster #507

 

Time for Return-to-Sports in Athletic Iliopsoas-Related Groin Pain: Analysis Distinguishing Peritendinitis and Muscle Strain Based on the Magnetic Resonance Imaging

Tadahiro Nihei, Saitama, Saitama JAPAN
Sadao Niga, MD, PhD, Saitama, Saitama JAPAN
Shoichiro Imamura, MS, Saitama, Saitama JAPAN
Yosuke Suzuki, MS, Saitama, Saitama JAPAN
Kaoru Suzuki, Saitama, Saitama JAPAN
Jindou Hatanaka, Kawaguchi, Saitama JAPAN
Masayoshi Saito, MD, Tokyo, Chuo-ku JAPAN
Sachiyuki Tsukada, MD, PhD, Mito, Ibaraki JAPAN

JIN Orthopaedic & Sports Clinic, Saitama, Saitama, JAPAN

FDA Status Not Applicable

Summary

46 athletes having long and thin lesion upward along iliopsoas tendon on MRI (peritendinitis type) had significantly longer time for return-to-sports than 54 athletes having massive lesion in muscle belly of iliopsoas with clear border (muscle strain type); 20.4 versus 8.6 weeks, p < 0.01. The MRI classification would be useful for the athletes with iliopsoas-related groin pain.

Abstract

Background

We advocated new magnetic resonance imaging (MRI) classification for iliopsoas-related athletic groin pain and compared the time for return-to-sports between the types of new classification.

Methods

Of the consecutive 134 athletes having signal intensity change in iliopsoas on MRI, 100 athletes (17 females and 83 males, mean 17 year-old), who were followed up to return-to-sports, were included in this study. We classified the high signal on short time inversion recovery (STIR) MRI into two types: muscle strain type (massive high signal area in muscle belly of iliopsoas with clear border) and peritendinitis type (long and thin high signal area upward along iliopsoas tendon without clear border). We compared the time from the onset of groin pain to the defection from sports and the time for return-to-sports between the two types using student’s t-test. The rate of patients doing sports including kicking was assessed with use of chi-squared test. As subgroup analysis, we compared the time for return-to-sports between patients of kicking sports and those of non-kicking sports in each muscle strain type and peritendinitis type.

Results

46 athletes were classified as peritendinitis type, and 54 athletes were classified as muscle strain type. The time from the onset of groin pain to the defection from sports was significantly longer in peritendinitis type than muscle strain type (7.1 ± 9.7 weeks and 2.2 ± 7.5 weeks, respectively, p < 0.01). The time from the onset of groin pain to return-to-sports was significantly longer in peritendinitis type than muscle strain type (20.4 ± 14.0 weeks and 8.6 ± 8.3 weeks, respectively, p < 0.01). The time from taking MRI to return-to-sports was significantly longer in peritendinitis type than muscle strain type (12.2 ± 9.6 weeks and 6.2 ± 3.5 weeks, respectively, p < 0.01). The rate of patients doing kicking sports was not significantly different between the two types (76.1 % in peritendinitis type and 68.5 % in muscle strain type, respectively, p = 0.40). In the subgroup analysis of muscle strain type, the patients doing kicking sports had significantly longer time from taking MRI to return-to-sports than those of doing non-kicking sports (7.1 ± 3.4 weeks and 4.1 ± 2.7 weeks, respectively, p < 0.01). In peritendinitis type, there was not significant difference between patients of kicking sports and those of non-kicking sports in the time from taking MRI to return-to sports (12.9 ± 10.1 weeks and 10.1 ± 7.9 weeks, respectively, p = 0.41).

Discussion

On the MRI classification for the high signal on STIR of iliopsoas, peritendinitis type had significantly longer time for return-to-sports than muscle strain type. Different treatment approaches would be appropriate to these two types. The reason why athlete doing kicking sports had longer time for return-to-sports than athletes doing non-kicking sports in muscle strain type may be that kicking would be difficult before healing muscle damage of iliopsoas.