What is MRI testing and how does it work?

EXPLAINED What is MRI testing and how does it work?

Solace Chukwu 14:46 - 11.01.2023

MRI testing has decimated the Cameroon and DR Congo squads for the U-17 AFCON, with the latter pulling out altogether. What is this age verification technology and how reliable is it?

African youth football has once again been rocked by an age verification scandal. 

A week ago, magnetic resonance imaging (MRI) testing ordered by Cameroon FA boss Samuel Eto’o ruled as many as 32 players out of the upcoming 2023 Under-17 Africa Cup of Nations regional qualifiers. 

While Cameroon have, according to reports, been able to find replacements in time, DR Congo have not been so lucky. They have been forced to pull out of the qualifiers altogether upon the discovery that 25 of their 40-strong squad failed MRI testing as well.

What is MRI?

Magnetic resonance imaging is a noninvasive medical imaging test that produces detailed images of almost every internal structure in the human body, including the organs, bones, muscles and blood vessels. (Johns Hopkins Medicine)

It is usually a diagnostic test but, unlike x-rays, MRI scans do not introduce radiation to the body; instead, magnetic and radio waves are used.

Hand and wrist MRI Hand and wrist MRI

Since 2009, MRI testing has been used by FIFA to determine whether players are overaged or not. Previously, standard radiographs were used to determine “skeletal age”, but ethical concerns over radiation doses led to the adoption of MRI testing instead.

In 2011, CAF adopted the use of MRI testing, using it for the first time in that year’s Under-17 AFCON in Rwanda.

How does it work?

For the purpose of determining whether a player falls within a certain age range, an MRI scan of the wrist is taken. 

Based on the fusion or otherwise of the distal radius (the radius is one of the two bones of the forearm; the distal radius is the part of the radius that connects directly to the joint of the wrist), the player’s eligibility to compete at under-17 level is determined. An incomplete fusing of the wrist bones can indicate certainty (up to 99 percent, according to a 2007 study conducted by its Medical Assessment and Research Center and published in the British Journal of Sports Medicine) that the player is no older than 17. 

Interestingly, according to neurologist Professor Jiri Dvorak, “the efficiency (of the test) stops at 17”; beyond that age, the deterministic quality of MRI testing fails.

Is it foolproof?

While the study on which the methodology is based cites a 99% accuracy, more recent studies have shown this estimate to be a generous one. 

For instance, in a 2015 study, it was found that MRI testing on female football players found only a 7.3% correlation between their chronological ages and the degree of distal radius fusion. This implies that MRI testing as a means of determining age eligibility in women’s football is more or less worthless.

There is also the fact that the study on which the methodology is based uses averages rather than individuals. In reality, there is a wide range of possibilities when it comes to the degree of wrist fusion even within the same age groups. Not only do some people’s wrist bones fuse earlier, some also fuse later: a more realistic range of 16 to 20 has been put forward by further studies and analysis. And this is without taking into account factors such as nutrition and genetics, concerns which are more relevant in some societies than in others.

Does that mean the implicated Cameroon and DR Congo players are innocent?

No, it does not mean that. Not necessarily, at least. While there are questions around the efficiency of MRI testing, it is not entirely without merit in male football. 

Why is it always Africans implicated?

Due to the paucity of birth records in Africa, age cheating has long been a problem on the continent. 

In 2007, following Nigeria’s victory on penalties at that year’s FIFA Under-17 World Cup, Spain coach Juan Santisteban was livid. “I respect what other people think about the improving Africans,” he said. “But the players on my team are all under 17 years old. I would really like to know the exact ages of players on Nigeria.”

Nigeria claimed their second crown at under-17 level in 2007, sparking allegations of age cheating in the aftermath. (IMAGO/AFLOSPORT) Nigeria claimed their second crown at under-17 level in 2007, sparking allegations of age cheating in the aftermath. (IMAGO/AFLOSPORT)

As recently as 2019, Guinea were kicked out of the Under-17 World Cup after they were found to have falsified the ages of two of their players.

While it is not actually always African sides being penalised (historically, countries from Asia to South America have been implicated in age cheating, after all), it is clearly a scourge that African football would do well to address. Short of addressing the broader socio-cultural problem, MRI testing is still the next best thing. 

In these present scenarios, kudos should go to the FAs of Cameroon and DR Congo for instituting the testing at an early point; it demonstrates their commitment to rooting out age cheating, even (in the case of the latter) to the detriment of their own immediate interests.

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