Pubic apophyseal MRI findings in asymptomatic elite youth soccer players: a cross-sectional comparison with non-athletes.

OBJECTIVE

To determine the prevalence of MRI findings of pubic apophysitis in asymptomatic elite youth soccer players compared with non-athletes and to evaluate other pelvic and hip abnormalities in both groups.

MATERIALS AND

METHODS

This cross-sectional observational study included asymptomatic elite male youth soccer players and male non-athletes matched by age and body mass index. Forty-seven soccer players who underwent pelvic MRI for complaints unrelated to the pelvis and had no current groin pain were recruited. A control group of 114 non-athletes was retrospectively identified from the PACS database. These individuals had undergone pelvic MRI primarily for low back pain or other indications and were asymptomatic for hip and groin pain at the time of imaging. MRI examinations were independently reviewed by two musculoskeletal radiologists blinded to clinical data and group allocation. Interobserver agreement was assessed for all variables. Between-group comparisons were performed using regression models adjusted for age and body mass index.

RESULTS

After application of the eligibility criteria, 40 athletes and 32 controls were included. Compared with controls, athletes showed a higher prevalence of MRI findings related to pubic apophysitis, including subapophyseal bone marrow edema (77.5% vs 18.8%; p < 0.01), bilateral widening between the apophyses and the subapophyseal bone (15.0%-40.0% vs 0%-6.2%; p < 0.05), cortical irregularity of the subapophyseal bone (82.5% vs 25.0%; p < 0.01), and pubic osteophytes (40.0% vs 3.1%; p = 0.01). Other findings more frequently observed in athletes included adductor longus tendinosis, adductor longus peritendinitis, trochanteric bursitis, and iliotibial band syndrome. Interobserver agreement ranged from moderate to almost perfect for most variables.

CONCLUSION

Asymptomatic elite youth soccer players demonstrate a high prevalence of MRI findings related to pubic apophysitis compared with non-athletes.