Diagnostic and prognostic value of clinical findings in 83 athletes with posterior thigh injury: comparison of clinical findings with magnetic resonance imaging documentation of hamstring muscle strain.
BACKGROUND
Little is known about the clinical features of posterior thigh injuries and their contribution to accurate diagnosis and prognostic assessment of hamstring muscle strain injury.


OBJECTIVE
The clinical features of posterior thigh injury can be used to diagnose hamstring muscle strain and to predict duration of absence from competition.


METHODS
Prospective clinical study.


METHODS
For two playing seasons, the clinical features of posterior thigh injury, timing of injury, and playing days lost were recorded for Australian Rules football players. Magnetic resonance imaging was used to confirm hamstring muscle injury.


RESULTS
Posterior thigh injuries associated with pain and tenderness were recorded for 83 players, with magnetic resonance imaging confirming hamstring injury in 68 (82%). Most of the hamstring injuries were sudden onset (62; 91%) and occurred after a significant warm-up period (57; 84%). Of the patients whose injuries were sudden onset and occurred after the warm-up period (N = 59), 57 (97%) had hamstring muscle strain detected on magnetic resonance imaging. Hamstring muscle injury confirmed by magnetic resonance imaging was associated with a longer absence from competition (mean, 27 days) than injuries where no hamstring injury was detected (mean, 16 days).


CONCLUSIONS
The clinical features of hamstring injury typically include sudden onset, pain, and tenderness, although exceptions do occur. Muscle fatigue may be important in the pathogenesis of hamstring injury.
Verrall
Geoffrey M
GM
SPORTSMED*SA Sports Medicine Clinic, Adelaide, Australia.
Slavotinek
John P
JP
Barnes
Peter G
PG
Fon
Gerald T
GT
D000328:Adult; D016009:Chi-Square Distribution; D005538:Football / Q000293:injuries*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D018482:Muscle, Skeletal / Q000293:injuries*; D010808:Physical Examination; D011379:Prognosis; D011446:Prospective Studies; D013180:Sprains and Strains / Q000175:diagnosis*; D013848:Thigh / Q000293:injuries*