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Hamstring injuries and predicting return to play: ‘bye-bye MRI?’
  1. G Reurink1,
  2. R Whiteley2,3,
  3. J L Tol4,5
  1. 1Department of Orthopaedics, Erasmus Medical Centre, Rotterdam, The Netherlands
  2. 2Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
  3. 3University of Sydney, Sydney, New South Wales, Australia
  4. 4Department of Sports Medicine, Aspetar, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
  5. 5Amsterdam Center of Evidence Based Sports Medicine, Academic Medical Center, Amsterdam, The Netherlands
  1. Correspondence to Dr G Reurink, Department of Orthopaedics, Erasmus Medical Centre, PO Box 2040, 3000 CA Rotterdam, Rotterdam 3000 CA, The Netherlands; guusreurink{at}hotmail.com

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“Quick—get an MRI so we know when he will be back ready to play”

In the elite athlete setting, MRI has gradually gained a magical reputation: it is the crystal ball that answers all the questions of the injured athlete, coaching and medical staff. Without imaging the injury, there is no peace of mind within the team. There is no doubt that the evolution of imaging techniques can support the management of the injured athlete, but we argue that the current available data suggests that it is almost useless for predicting return to play (RTP) following hamstring injury.

If you think a grade II injury will take 4 weeks, it will take 4 weeks irrespective of when the player was ready

In a recently published systematic review of the literature, we concluded that there is no strong evidence for any MRI finding that can guide sports physicians and radiologists in predicting prognosis for the time to RTP after an acute hamstring injury.1 This conclusion is mainly based on two limitations in the current literature:

  1. Multiple studies on hamstring injuries found correlations between different MRI measures and the time to RTP. Unfortunately, these are limited to univariate analyses …

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