{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T21:12:57Z","timestamp":1790025177113,"version":"4.0.1"},"reference-count":19,"publisher":"FapUNIFESP (SciELO)","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Radiol Bras"],"abstract":"<jats:p>Abstract  Objective: To evaluate, primarily, the accuracy of plain radiography (X-ray) in diagnosing apophyseal avulsion fractures in adolescent soccer players, using magnetic resonance imaging (MRI) as the gold standard. As secondary objectives, we investigated associations between findings on X-ray, MRI, and power Doppler, as well as the imaging features that distinguish avulsion fractures from apophysitis.  Materials and Methods: This was an observational cross-sectional study involving 33 male athletes 9-17 years of age with clinical suspicion of an apophyseal avulsion fracture. Imaging examinations were performed within the first 24 h after the trauma. We evaluated diagnostic reproducibility among readers, the accuracy of X-ray compared with MRI, and the associations between findings from different imaging methods.  Results: We found that X-ray had an accuracy of 56.0%, with high specificity (71.4%) and positive predictive value (81.8%), although its sensitivity and negative predictive value were relatively low (50.0% and 35.7%, respectively). The power Doppler result was significantly associated with avulsion fractures detected on MRI (p = 0.0144). Avulsion fractures were associated with periphyseal edema and intermuscular fluid collections, while apophysitis was associated with bone marrow edema.  Conclusion: X-ray is useful for confirming, but not for excluding, avulsion fractures. Power Doppler and MRI contribute to the differential diagnosis.<\/jats:p>","DOI":"10.1590\/0100-3984.2025.0059","type":"journal-article","created":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T15:06:38Z","timestamp":1768575998000},"source":"Crossref","is-referenced-by-count":1,"title":["Multimodal imaging of apophyseal avulsion fractures in adolescent soccer players: contributions of plain radiography, power Doppler, and magnetic resonance imaging"],"prefix":"10.1590","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7610-2404","authenticated-orcid":false,"given":"Roberto","family":"Mogami","sequence":"first","affiliation":[{"name":"Universidade do Estado do Rio de Janeiro,  Brazil; Hospital Universit\u00e1rio Pedro Ernesto,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9436-487X","authenticated-orcid":false,"given":"Claudio Henrique Ivo de Ara\u00fajo","family":"Ribeiro Filho","sequence":"additional","affiliation":[{"name":"Vasco da Gama Sociedade An\u00f4nima do Futebol,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9946-785X","authenticated-orcid":false,"given":"Eduardo Brown Guedes dos","family":"Santos","sequence":"additional","affiliation":[{"name":"Hospital Universit\u00e1rio Pedro Ernesto,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5384-7266","authenticated-orcid":false,"given":"Andr\u00e9 de Almeida","family":"Vieira","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio de Janeiro,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4588-7198","authenticated-orcid":false,"given":"Lucas Nascimento da","family":"Luz","sequence":"additional","affiliation":[{"name":"Universidade do Estado do Rio de Janeiro,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7472-0428","authenticated-orcid":false,"given":"Caio Leal","family":"Leidersnaider","sequence":"additional","affiliation":[{"name":"Faculdade de Ci\u00eancias M\u00e9dicas de Tr\u00eas Rios,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8938-8165","authenticated-orcid":false,"given":"Nat\u00e1lia Fernandes de","family":"Azevedo","sequence":"additional","affiliation":[{"name":"Hospital Universit\u00e1rio Pedro Ernesto,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8797-7380","authenticated-orcid":false,"given":"Edson","family":"Marchiori","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio de Janeiro,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1026-8639","authenticated-orcid":false,"given":"Paulo S\u00e9rgio Chagas","family":"Gomes","sequence":"additional","affiliation":[{"name":"Instituto de Educa\u00e7\u00e3o F\u00edsica e Desportos,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2025]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1007\/s00256-023-04542-x","article-title":"Apophyseal injuries in soccer players","volume":"54","author":"Sato VN","year":"2025","journal-title":"Skeletal Radiol"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1016\/j.rehab.2010.08.030","article-title":"Anterior superior iliac spine avulsion in a young soccer player","volume":"53","author":"Bendeddouche I","year":"2010","journal-title":"Ann Phys Rehabil Med"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"2273","DOI":"10.1007\/s00256-021-03797-6","article-title":"Hip apophyseal injuries in soccer players: can MRI findings be useful to define when to return to play?","volume":"50","author":"Yamada AF","year":"2021","journal-title":"Skeletal Radiol"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"147","DOI":"10.13107\/jocr.2024.v14.i05.4466","article-title":"Magnetic resonance imaging in the evaluation of avulsion injuries of the pelvis and hip in adolescent professional footballers: a case series","volume":"14","author":"Cirimele V","year":"2024","journal-title":"J Orthop Case Rep"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"23259671211065063","DOI":"10.1177\/23259671211065063","article-title":"Apophysitis among male youth soccer players at an elite soccer academy over 7 seasons","volume":"10","author":"Gudelis M","year":"2022","journal-title":"Orthop J Sports Med"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"e000428","DOI":"10.1136\/rmdopen-2016-000428","article-title":"Scoring ultrasound synovitis in rheumatoid arthritis: a EULAR-OMERACT ultrasound taskforce - Part 1: definition and development of a standardised, consensus-based scoring system","volume":"3","author":"D\u2019Agostino MA","year":"2017","journal-title":"RMD Open"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1186\/s12891-020-03287-1","article-title":"Diagnosis of avulsion fractures of the distal fibula after lateral ankle sprain in children: a diagnostic accuracy study comparing ultrasonography with radiography","volume":"21","author":"Takakura Y","year":"2020","journal-title":"BMC Musculoskelet Disord"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"1555","DOI":"10.1002\/jum.14488","article-title":"Color Doppler sonography accompanied by dynamic scanning for the diagnosis of ankle and foot fractures","volume":"37","author":"Oh MJ","year":"2018","journal-title":"J Ultrasound Med"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.1016\/S0196-0644(05)80994-1","article-title":"Avulsion of the iliac crest apophysis: a rare fracture in adolescent athletes","volume":"22","author":"Lambert MJ","year":"1993","journal-title":"Ann Emerg Med"},{"key":"ref10","first-page":"5667","article-title":"Avuls\u00f5es em jogadores de futebol adolescentes: resultados preliminares de achados radiogr\u00e1ficos, ultrassonogr\u00e1ficos e de resson\u00e2ncia magn\u00e9tica","volume":"7","author":"Vieira AA","year":"2024","journal-title":"Braz J Health Rev"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1007\/s002560000319","article-title":"Acute avulsion fractures of the pelvis in adolescent competitive athletes: prevalence, location and sports distribution of 203 cases collected","volume":"30","author":"Rossi F","year":"2001","journal-title":"Skeletal Radiol"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1055\/a-1082-1598","article-title":"Avulsion injuries of the pelvis and hip","volume":"192","author":"Albtoush OM","year":"2020","journal-title":"Rofo"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1097\/PHM.0000000000001307","article-title":"Ultrasound imaging and rehabilitation of muscle disorders: Part 1. 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