Relações entre diagnóstico por imagem e marcadores bioquímicos para detecção de lesões musculares no futebol

Abstract

Among the complications affecting football players, muscular injuries constitute a significant challenge for professional football teams. They manifest in various degrees and their diagnosis poses a consistent challenge for the coaching staff and respective medical departments. Recent studies focusing on professional footballers have revealed that thigh muscle injuries account for over 30% of all injuries and result in the majority of absences and missed training and competition days. As a consequence, this thesis aims to scrutinize the diagnosis of acute and subacute muscular injuries through biochemical markers and imaging in football athletes presenting clinical suspicion of muscular injury. Initially, Study 1, a systematic review, examined twenty-four studies that establish correlations among football, muscular injury, and diagnostic imaging. This review sought to map and evaluate the existing intellectual output, with the purpose of defining and generating further knowledge via a novel experimental study. The findings revealed two imaging modalities employed for muscular injury assessment: 66.67% of the documents focused on Magnetic Resonance Imaging (MRI), 20.83% on Ultrasonography, and 12.50% on the combination of both methods. Notably, in terms of tracking injury progression, ultrasonography demonstrated a higher precision compared to MRI. Study 2 aimed to identify the anthropometric characteristics of professional football players in the Brazilian army, based on their playing positions, and to discern differences, enabling comparisons with other teams competing in professional football leagues within the same category or across different categories. Subsequently, addressing the knowledge gap identified in the systematic review, Study 3 was conducted to explore the relationships between imaging methods—ultrasonography and infrared thermography—and biochemical markers, namely Creatine Kinase (CK) and Lactate Dehydrogenase (LDH), for diagnosing football- related muscular injuries. This analysis underscores the significance of individualizing athlete assessment and diagnosis. Infrared thermography and ultrasonography were utilized as imaging techniques. Biochemical evaluation of athletes' blood samples was conducted at the EsEFEx laboratory within a group of 27 athletes from the Brazilian Army Military Selection, participating in the 2023 Campeonato Carioca Serie B. Notably, injuries were more prevalent among midfielders, defenders, and forwards during matches. Ultrasonography-detected injuries were linked to muscular asymmetry, as evidenced by Infrared Thermography, and were accompanied by elevated CK and LDH biomarkers. A total of 5 athletes were diagnosed with injuries, among whom 4 exhibited hypothermia and 1 displayed hyperthermia in the injury- affected region. The occurrence of injuries on the dominant (right) side was observed in 3 athletes. The combination of imaging methods (US and TIV) with biochemical markers (CK and LDH) proved to be beneficial and promising for diagnosing football-related injuries, potentially preventing injury exacerbation due to missed diagnosis. This approach aligns with injury prevention logic in sports, employing more accessible imaging diagnostic methods