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Imaging-detected acute muscle injuries in athletes participating in the Rio de Janeiro 2016 Summer Olympic Games
  1. Michel D Crema1,2,3,
  2. Mohamed Jarraya1,4,
  3. Lars Engebretsen5,6,7,
  4. Frank W Roemer1,8,
  5. Daichi Hayashi1,9,
  6. Romulo Domingues10,
  7. Abdalla Y Skaf11,
  8. Ali Guermazi1
  1. 1 Department of Radiology, Quantitative Imaging Center, Boston University School of Medicine, Boston, Massachusetts, USA
  2. 2 Department of Radiology, Saint-Antoine Hospital, University Paris VI, Paris, France
  3. 3 Department of Sports Medicine, National Institute of Sports (INSEP), Paris, France
  4. 4 Department of Radiology, Mercy Catholic Medical Center, Darby, Pennsylvania, USA
  5. 5 Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
  6. 6 Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo Sports Trauma Research Center, Oslo, Norway
  7. 7 Department of Orthopedic Surgery, Oslo University Hospital, University of Oslo, Oslo, Norway
  8. 8 Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany
  9. 9 Department of Radiology, Stony Brook University School of Medicine, Stony Brook, New York, USA
  10. 10 Department of Radiology, Clinica de Diagnostico Por Imagem (CDPI) and Multi-Imagem, Rio de Janeiro, Brazil
  11. 11 Department of Radiology, HCor Hospital and ALTA Diagnostic Center (DASA group), Sao Paulo, Brazil
  1. Correspondence to Dr Michel D Crema, Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA 02118, USA; michelcrema{at}


Background Acute muscle injuries in elite athletes are responsible for a large portion of time loss injuries.

Aim To describe the frequency, the anatomic distribution, and severity of imaging-detected acute muscle injuries among athletes who competed in the Rio de Janeiro 2016 Summer Olympics.

Methods We recorded all sports injuries reported by the National Olympic Committee medical teams and the Organising Committee medical staff during the 2016 Summer Olympics. Imaging of acute muscle injuries was performed at the IOC’s polyclinic within the Olympic Village using ultrasound and 3.0 T and 1.5 T MRI scanners. The assessment of images was performed centrally by three musculoskeletal radiologists. The distribution of injuries by anatomic location and sports discipline and the severity of injuries were recorded.

Results In total, 11 274 athletes from 207 teams were included. A total of 1101 injuries were reported. Central review of radiological images revealed 81 acute muscle injuries in 77 athletes (66% male, mean age: 25.4 years, range 18–38 years). Athletics (track and field) athletes were the most commonly affected (n=39, 48%), followed by football players (n=9, 11%). The majority of injuries affected muscles from lower limbs (n=68, 84%), with the hamstring being the most commonly involved. Most injuries were grade 2 injuries according to the Peetrons classification (n=44, 54%), and we found 18 injuries exhibiting intramuscular tendon involvement on MRI.

Conclusion Imaging-detected acute muscle injuries during the 2016 Summer Olympics affected mainly thigh muscles in athletics disciplines.

  • muscle injury
  • olympic games
  • ultrasound
  • MRI

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  • Contributors All coauthors of the manuscript have fulfilled the following criteria: substantial contributions to the conception or design of the work, or the acquisition, analysis or interpretation of data; drafting the work or revising it critically for important intellectual content; final approval of the version published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Competing interests AG is the president of Boston Imaging Core Lab (BICL) and a consultant to Merck Serono, AstraZeneca, Pfizer, GE Healthcare, OrthoTrophix, Sanofi and TissueGene. FWR and MDC are shareholders of BICL. LE is a consultant to Arthrex and Smith & Nephew.

  • Ethics approval Our retrospective study was reviewed by the Medical Research Ethics Committee of the South-Eastern Norway Regional Health Authority (2011/388) and was exempted from Ethics Committee approval.

  • Provenance and peer review Not commissioned; externally peer reviewed.