Hamstring Muscle Complex: An Imaging Review

Abstract

Increasing activity in the general population and the high demands placed on athletes have resulted in injuries to the hamstring muscle complex (HMC) being commonplace in sports. Imaging of HMC injuries can form a considerable part of a sports medicine practice, with a wide spectrum of such injuries being reflected in their varied imaging appearances. Magnetic resonance (MR) imaging and ultrasonography (US) are the imaging modalities of choice in this setting. Both MR imaging and US provide exquisitely detailed information about the HMC with respect to localization and characterization of injury. Optimization of MR imaging involves the use of a surface coil and high-resolution techniques, allowing the musculoskeletal radiologist not only to diagnose injury and assess severity but also to provide the clinician with useful clues with respect to prognosis. The portability and availability of US make it an attractive modality for the diagnosis of acute hamstring injuries, although its effectiveness is dependent on operator experience. A thorough knowledge of the HMC anatomy and of the spectrum of imaging findings in HMC injury is crucial for providing optimal patient care and will enable the musculoskeletal radiologist to make an accurate and useful contribution to the treatment of athletes at all levels of participation.

Evaluation and Imaging of an Untreated Grade III Hamstring Tear: A Case Report

“…This, together with the capability to evaluate multiple anatomic planes, make it the most suitable technique to evaluate muscle injures [23][24][25][26]. Most muscle injuries might not require imaging, but as this noninvasive technology continues to improve and becomes even more commonplace, it can play a role in rehabilitation planning and prognosis [3].…”

MR Imaging of Muscle Trauma: Anatomy, Biomechanics, Pathophysiology, and Imaging Appearance

“…The interdigitation between muscle and tendon fibers typically takes place over several centimeters, either within or on the surface of the muscle, so the MTJ is not discrete, as it is in parallel muscles; rather, it is a long transition zone (27). Oblique attachment relative to the line of tendon traction results in a greater surface area for insertion, allowing packing of more fibers per volume, giving rise to greater force.…”

“…This pattern of injury is common at the distal gastrocnemius and soleus as their aponeuroses converge to form the Achilles tendon (27) (Fig 11). Tennis leg injuries of the calf involving these muscles demonstrate fluid accumulation in up to 50% of cases, characteristically between the unipennate gastrocnemius and soleus, whose aponeuroses lack adherence proximally due to the presence of an interposed plantaris tendon (31) (Fig 12).…”

Hamstring Strain in Soccer Players: Things the Trainer Must Know

“…In the event edema and hemorrhage occur in the injured area, these two imaging methods make it possible to make a diagnosis [24]. Magnetic resonance imaging is considered preferable when damage is found inside the muscle tissue, or for example, when mild local edema exists or when an old scar is present as a result of a previous injury [12,13,25].…”