The Role of Magnetic Resonance Imaging in Sports Injuries: Current Applications and Clinical Importance - A Narrative Review
DOI:
https://doi.org/10.12775/QS.2026.65.74181Keywords
Keywords: magnetic resonance imaging, sports injuries, musculoskeletal imaging, anterior cruciate ligament, meniscal injuries, muscle injuries, Achilles tendon, bone stress injuries, quantitative MRI, artificial intelligenceAbstract
Background. Magnetic resonance imaging (MRI) is the reference imaging modality for evaluating sports-related musculoskeletal injuries because of its excellent soft tissue contrast and ability to assess ligaments, tendons, muscles, cartilage, and bone marrow without ionizing radiation.
Aim. To summarize the clinical applications of MRI in the diagnosis and management of sports-related musculoskeletal injuries and discuss emerging developments in quantitative MRI and artificial intelligence (AI).
Material and methods. A narrative review of recent reviews, systematic reviews, meta-analyses, and original studies on MRI in sports medicine was performed.
Results. Conventional MRI remains essential for diagnosing anterior cruciate ligament tears, meniscal injuries, muscle injuries, Achilles tendon disorders, and bone stress injuries, supporting treatment planning and rehabilitation. Quantitative MRI enables assessment of tissue composition and microstructural changes beyond conventional imaging, while AI shows promise in image acquisition, reconstruction, automated analysis, and clinical decision support. However, further validation and protocol standardization are required.
Conclusions. MRI remains central to sports injury evaluation. Advances in quantitative MRI and AI may improve diagnostic accuracy, workflow efficiency, and individualized patient management, although further prospective multicentre studies are needed before routine clinical implementation.
References
1. López-Valenciano A, Ruiz-Pérez I, Garcia-Gómez JA, et al. Epidemiology of injuries in professional football: a systematic review and meta-analysis. Br J Sports Med. 2020;54(12):711–718. https://doi.org/10.1136/bjsports-2018-099577.
2. Bahr R, Clarsen B, Derman W, et al. International Olympic Committee consensus statement: methods for recording and reporting of epidemiological data on injury and illness in sport 2020 (including STROBE Extension for Sport Injury and Illness Surveillance [STROBE-SIIS]). Br J Sports Med. 2020;54(7):372–389. https://doi.org/10.1136/bjsports-2019-101969.
3. Upadhyaya V, Choudur HN. Update on sports imaging. J Clin Orthop Trauma. 2021; 21:101555. https://doi.org/10.1016/j.jcot.2021.101555.
4. Isern-Kebschull J, Mechó S, Pedret C, et al. Muscle Healing in Sports Injuries: MRI Findings and Proposed Classification Based on a Single Institutional Experience and Clinical Observation. Radiographics. 2024;44(8): e230147. https://doi.org/10.1148/rg.230147.
5. Crema MD, Yamada AF, Guermazi A, et al. Imaging techniques for muscle injury in sports medicine and clinical relevance. Curr Rev Musculoskelet Med. 2015;8(2):154–161. https://doi.org/10.1007/s12178-015-9260-4.
6. Rubin EB, Schmidt AM, Koff MF, et al. Advanced MRI Approaches for Evaluating Common Lower Extremity Injuries in Basketball Players: Current and Emerging Techniques. J Magn Reson Imaging. 2024;59(6):1902–1913. https://doi.org/10.1002/jmri.29019.
7. Casula V, Kajabi AW. Quantitative MRI methods for the assessment of structure, composition, and function of musculoskeletal tissues in basic research and preclinical applications. Magn Reson Mater Phys Biol Med. 2024, https://doi.org/10.1007/s10334-024-01174-7.
8. Ahn JM, El-Khoury GY. Role of magnetic resonance imaging in musculoskeletal trauma. Top Magn Reson Imaging. 2007;18(3):155-168. https://doi.org/10.1097/RMR.0b013e318093e670.
9. Hash TW. Magnetic resonance imaging of the knee. Sports Health. 2013;5(1):78-107. https://doi.org/10.1177/1941738112468416.
10. Nacey NC, Geeslin MG, Miller GW, Pierce JL. Magnetic resonance imaging of the knee: An overview and update of conventional and state-of-the-art imaging. J Magn Reson Imaging. 2017;45(5):1257–1275. https://doi.org/10.1002/jmri.25620.
11. Dubey A, Shashank C, Rajmohamed RF, et al. Imaging in Sports Injuries. Apollo Medicine. 2026;23(1):82–94. https://doi.org/10.1177/09760016251400028.
12. Allott NEH, O'Brien J, Kew M, et al. (2022), Evaluating the diagnostic pathway for acute anterior cruciate ligament injuries in trauma centres: a systematic review. BMC Musculoskeletal Disorders. 2022; 23:629. https://doi.org/10.1186/s12891-022-05595-0.
13. Huang Z, Liu Z, Fan C, Zou M, Chen J. Value of clinical tests in diagnosing anterior cruciate ligament injuries: a systematic review and meta-analysis. Medicine (Baltimore). 2022;101(31): e29263. https://doi.org/10.1097/MD.0000000000029263.
14. Guenoun D, Le Corroller T, Amous Z, et al. The contribution of MRI to the diagnosis of traumatic tears of the anterior cruciate ligament. Diagnostic and Interventional Imaging. 2012;93(5):331–341. https://doi.org/10.1016/j.diii.2012.02.003.
15. Ali A. Evaluation of Magnetic Resonance Imaging (MRI) versus Knee Arthroscopy in Diagnosing ACL Tears: A Systematic Review. Asian Journal of Medicine and Biomedicine. 2023;7(2):53–65. https://doi.org/10.37231/ajmb.2023.1.S.669.
16. Phelan N, Rowland P, Galvin R, et al. A systematic review and meta-analysis of the diagnostic accuracy of MRI for suspected ACL and meniscal tears of the knee. Knee Surgery, Sports Traumatology, Arthroscopy. 2016;24(5):1525–1539. https://doi.org/10.1007/s00167-015-3861-8.
17. Bolog NV, Andreisek G. Reporting knee meniscal tears: technical aspects, typical pitfalls and how to avoid them. Insights Imaging. 2016;7(3):385–398. https://doi.org/10.1007/s13244-016-0472-y.
18. Moreira J, Almeida M, Lunet N, et al. Ramp lesions: a systematic review of MRI diagnostic accuracy and treatment efficacy. Journal of Experimental Orthopaedics. 2020; 7:71. https://doi.org/10.1186/s40634-020-00287-x.
19. Crema MD, Roemer FW, Marra MD, et al. Articular cartilage in the knee: current MR imaging techniques and applications in clinical practice and research. Radiographics. 2011;31(1):37–61. https://doi.org/10.1148/rg.311105084.
20. Potter HG, Jain SK, Ma Y, et al. Cartilage injury after acute, isolated anterior cruciate ligament tear: immediate and longitudinal effect with clinical/MRI follow-up. Am J Sports Med. 2012;40(2):276-285. https://doi.org/10.1177/0363546511423380.
21. Koulouris G, Connell DA. Hamstring muscle complex: an imaging review. Radiographics. 2005;25(3):571–586. https://doi.org/10.1148/rg.253045711.
22. Grange S, Reurink G, Nguyen AQ, et al. Location of Hamstring Injuries Based on Magnetic Resonance Imaging: A Systematic Review. Sports Health. 2023;15(1):111–123. https://doi.org/10.1177/19417381211071010.
23. Askling CM, Tengvar M, Saartok T, et al. Acute first-time hamstring strains during high-speed running: a longitudinal study including clinical and magnetic resonance imaging findings. Am J Sports Med. 2007;35(2):197–206. https://doi.org/10.1177/0363546506294679.
24. Szaro P, Nilsson-Helander K, Carmont M. MRI of the Achilles tendon—A comprehensive pictorial review. Part one. Eur J Radiol Open. 2021;8:100342. https://doi.org/10.1016/j.ejro.2021.100342.
25. Khan KM, Forster BB, Robinson J, et al. Are ultrasound and magnetic resonance imaging of value in assessment of Achilles tendon disorders? A two-year prospective study. Br J Sports Med. 2003;37(2):149–153. https://doi.org/10.1136/bjsm.37.2.149.
26. Garras DN, Raikin SM, Bhat SB, et al. MRI is unnecessary for diagnosing acute Achilles tendon ruptures: clinical diagnostic criteria. Clin Orthop Relat Res. 2012;470(8):2268–2273. https://doi.org/10.1007/s11999-012-2355-y.
27. Warden SJ, Davis IS, Fredericson M. Management and Prevention of Bone Stress Injuries in Long-Distance Runners. J Orthop Sports Phys Ther. 2014;44(10):749–765. https://doi.org/10.2519/jospt.2014.5334.
28. Song SH, Koo JH. Bone Stress Injuries in Runners: a Review for Raising Interest in Stress Fractures in Korea. J Korean Med Sci. 2020;35(8): e38. https://doi.org/10.3346/jkms.2020.35.e38.
29. Esh R, Grødahl LHJ, Kerslake R, et al. Diagnostic accuracy of MRI for identifying posterior element bone stress injury in athletes with low back pain: a systematic review and narrative synthesis. BMJ Open Sport Exerc Med. 2020;6: e000764. https://doi.org/10.1136/bmjsem-2020-000764.
30. Hoenig T, Tenforde AS, Strahl A, et al. Does Magnetic Resonance Imaging Grading Correlate with Return to Sports After Bone Stress Injuries? A Systematic Review and Meta-analysis. Am J Sports Med. 2022;50(3):834–844. https://doi.org/10.1177/0363546521993807.
31. Hayashi D, Roemer FW, Tol JL, et al. Emerging Quantitative Imaging Techniques in Sports Medicine. Radiology. 2023;308(2): e221531. https://doi.org/10.1148/radiol.221531.
32. Monte JR, Biglands JD, Cassidy PJ, et al. Diffusion tensor imaging and quantitative T2 mapping to monitor muscle recovery processes after acute hamstring injury. NMR Biomed. 2023; 36(7): e4902. https://doi.org/10.1002/nbm.4902.
33. Emanuel KS, Kellner LJ, Peters MJJ, et al. The relation between the biochemical composition of knee articular cartilage and quantitative MRI: a systematic review and meta-analysis. Osteoarthritis Cartilage. 2022;30(5):650–662. https://doi.org/10.1016/j.joca.2021.10.016.
34. Tong MW, Zhou J, Akkaya Z, et al. Artificial intelligence in musculoskeletal applications: a primer for radiologists. Diagnostic and Interventional Radiology. 2025;31(2):89–101. https://doi.org/10.4274/dir.2024.242830.
35. Guermazi A, Omoumi P, Tordjman M, et al. How AI May Transform Musculoskeletal Imaging. Radiology. 2024;310(1): e230764. https://doi.org/10.1148/radiol.230764.
36. Bien N, Rajpurkar P, Ball RL, et al. Deep-learning-assisted diagnosis for knee magnetic resonance imaging: development and retrospective validation of MRNet. PLoS Medicine. 2018;15(11): e1002699. https://doi.org/10.1371/journal.pmed.1002699.
37. Zhao Y, Coppola A, Karamchandani U, et al. Artificial intelligence applied to magnetic resonance imaging reliably detects the presence, but not the location, of meniscus tears: a systematic review and meta-analysis. European Radiology. 2024. https://doi.org/10.1007/s00330-024-10625-7.
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