title: Diagnosis and prognosis of acute hamstring injuries in athletes.
abstract: OBJECTIVE
  Identification of the most relevant diagnostic and prognostic factors of physical examination and imaging of hamstring injuries in (elite) athletes.
  
  
  METHODS
  A literature search was conducted in MEDLINE and EMBASE for articles between 1950 and April 2011. A survey was distributed among the members of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy, which focused on physical examination, prognosis, imaging and laboratory tests of hamstring injuries in (elite) athletes.
  
  
  RESULTS
  Medical history, inspection and palpation of the muscle bellies and imaging are most valuable at the initial assessment according to the literature. Experts considered medical history, posture and gait inspection, inspection and palpation of muscle bellies, range of motion tests, manual muscle testing, referred pain tests and imaging to be most important in the initial assessment of hamstring injuries. Magnetic resonance imaging (MRI) is preferred over ultrasonography and should take place within 3 days post-trauma. Important prognostic factors are injury grade, length of the muscle tear on MR images, MRI-negative injuries and trauma mechanism.
  
  
  CONCLUSIONS
  Posture and gait inspection, inspection and palpation of muscle bellies, range of motion tests, manual muscle testing and referred pain tests within 2 days post-trauma were identified as the most relevant diagnostic factors.
  
  
  METHODS
  Literature review and expert opinion, Level V.
authors.affiliation: ESSKA Sports Committee, Department of Orthopedic Surgery, Academic Medical Center, 1105 AZ, Amsterdam, The Netherlands. g.m.kerkhoffs@amc.nl
authors.forename: Gino M M J
authors.initials: GM
authors.lastname: Kerkhoffs
authors.forename: Nick
authors.initials: N
authors.lastname: van Es
authors.forename: Thijs
authors.initials: T
authors.lastname: Wieldraaijer
authors.forename: Inger N
authors.initials: IN
authors.lastname: Sierevelt
authors.forename: Jan
authors.initials: J
authors.lastname: Ekstrand
authors.forename: C Niek
authors.initials: CN
authors.lastname: van Dijk
mesh_terms: D001265:Athletic Injuries / Q000175:diagnosis*; D006801:Humans; D018482:Muscle, Skeletal / Q000293:injuries*; D010808:Physical Examination; D011379:Prognosis; D013848:Thigh / Q000293:injuries*