Seventy percent of healthy professional and collegiate hockey players had abnormal hip and pelvis MRIs (magnetic resonance imaging), even though they had no symptoms of injury, according to a study presented at the American Orthopaedic Society for Sports Medicine's Specialty Day in New Orleans, (March 13). The study's surprising findings could serve as a warning for surgeons to not depend excessively on imaging when diagnosing patients.
"This study was done to see if abnormal MRI results are found incidentally in active roster hockey players," said Matthew Silvis, MD, Assistant Professor, Department of Family Medicine and Orthopedics at Hershey Medical Center at Penn State University College of Medicine. "Unexpectedly, the majority of players had some abnormality in their MRI, but it didn't limit their playing ability. The study raises many questions, but its value to surgeons is to recognize that imaging doesn't replace good clinical judgment, which includes a detailed history and complete physical exam. This study might make you hesitate to read too much into an MRI."
In the study, high-resolution MRIs were taken of the pelvis and hips of 21 professional and 18 collegiate hockey players, aged 18 - 35. Of the 39 players, only two reported slight pain, which they identified as a 3 on a 10 point scale, with minimal to no disability in relation to their pain. Twenty-one out of the 39 (54 percent) had labral tears (tears in the structure that keeps the hip in place). Twelve of the 39 (31 percent) had muscle strain injuries of the hips and 2 of 39 (5 percent) had tendinosis (inflammation) of the hips. Overall, 70 percent of the players had irregular findings on their MRIs, but no clinical symptoms.
MRIs are noninvasive tests that help doctors diagnose and treat medical conditions. MRIs use a powerful magnetic field, radio frequency pulses and a computer to produce detailed pictures of organs, soft tissues, bone and many other internal body structures.
"This study raises all sorts of questions that should be examined in further studies. For example, will these abnormalities cause problems and symptoms later for these athletes?" said Silvis. "But this study shows the limitations of depending too heavily on an MRI. A surgeon may see something in the image, but it isn't causing a problem."