ArticleSkeletal radiology2026
Classification systems for assessing acute muscle injuries: a retrospective comparison of inter-reader agreements.
Article in Skeletal radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Imaging characterization of sports-related hamstring injuries.Skeletal radiology · 2026Review
- Imaging characterization and differential diagnosis of delayed-onset muscle soreness (DOMS) in athletes.Skeletal radiology · 2026Review
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Authors and funding
5 authors.
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No grant is acknowledged in the PubMed record.
Abstract
objectivesThe purpose of this study is to compare three commonly used classification systems for MRI grading of acute muscle injury concerning their inter-reader reliability.
methodsEthical committee approval was obtained. Inclusion criteria comprised patients with acute muscle injury, age ≥ 18 years, and signed informed consent. MR examinations were evaluated by four independent musculoskeletal radiologists. Muscle injuries were graded according to the British Athletics Muscle Injury Classification (BAMIC), the Munich Consensus Injury Classification (MCIC), and the Chan et al. Injury Classification (CIC). Inter-reader reliability was quantified with Fleiss' Kappa (κ) and associated 95% confidence interval (CI).
resultsOne hundred eleven acute muscle injuries in 110 patients (84% males) were assessed. Injured muscle groups included 85 thigh injuries (44 hamstrings, 41 non-hamstrings), 19 lower leg injuries, and 7 injuries in other locations. κ values (CI) were 0.506 (0.499, 0.514) for BAMIC, 0.566 (0.549, 0.584) for MCIC, and 0.306 (0.302, 0.311) for CIC. The highest reproducibility was seen for non-hamstring injuries in the thigh using MCIC 0.749 (0.720, 0.777), the lowest for lower leg injuries using CIC 0.199 (0.185, 0.213). Injury severity showed greater reproducibility (κ = 0.594-0.696) than the location of the injury within the muscle (κ = 0.349-0.576).
conclusionsThe MCIC and BAMIC demonstrate moderate inter-reader reliability, whereas the CIC demonstrates fair inter-reader reliability. The challenge with the classifications is the reproducibility of localizing the injury anatomically within the muscle, rather than classifying injury severity. Non-hamstring thigh injuries were most reproducible with MCIC, while lower leg injuries were least reproducible with CIC.
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