title: Evaluation of the hamstring muscle complex following acute injury.
abstract: OBJECTIVE
  To evaluate the imaging findings following acute hamstring injury.
  
  
  METHODS
  We retrospectively reviewed the imaging findings of hamstring muscle complex (HMC) strain in 170 patients referred to our institution over a 3-year period. A total of 179 injuries to the HMC were demonstrated in 170 patients (154 male, 16 female, mean age 28.2 years). The mean duration of symptoms was 4.7 days (range 1-10 days). MR imaging was performed in 97 cases and sonography in 102 cases (both modalities were performed in 20 examinations). Attention was directed to the frequency of muscle involvement, the location of the injury within the muscle-tendon unit, the extent of the injury and discriminating avulsion from muscle injury.
  
  
  CONCLUSIONS
  Twenty-one patients had proximal tendon injury, with sixteen avulsions and five partial tears. Sixteen of these patients had surgical confirmation of hamstring avulsion from the ischial tuberosity (14 conjoint, 2 biceps femoris alone) and all were reliably diagnosed with MR imaging (16/16), but less so with sonography (7/12). Four distal tendon avulsions were also observed (three semitendinosus, one biceps femoris). With respect to muscle injury, the biceps femoris was most commonly injured (124/154). Semimembranosus was an uncommon muscle injury (21/154) and semitendinosus rare (9/154). Imaging can discriminate a hamstring tendon avulsion from musculotendinous strain and helps identify which patients necessitate surgical management as opposed to conservative treatment.
authors.affiliation: Department of Radiology, St Francis X Cabrini, Wattletree Rd, 3144, Malvern, Victoria, Australia.
authors.forename: George
authors.initials: G
authors.lastname: Koulouris
authors.forename: David
authors.initials: D
authors.lastname: Connell
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology*; D011859:Radiography; D012189:Retrospective Studies; D013180:Sprains and Strains / Q000000981:diagnostic imaging / Q000473:pathology; D013708:Tendon Injuries / Q000000981:diagnostic imaging* / Q000473:pathology*; D013848:Thigh / Q000000981:diagnostic imaging; D014463:Ultrasonography