Imaging of hamstring injuries: therapeutic implications

Koulouris, George; Connell, David

doi:10.1007/s00330-005-0075-3

Cited by 72 publications

(64 citation statements)

References 64 publications

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“…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].…”

Section: Discussionmentioning

confidence: 99%

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

Clark

Henn

Lovering

2011

Clinical Orthopaedics &Amp; Related Research

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Background Muscle strains are one of the most common complaints treated by physicians. High-force lengthening contractions can produce very high forces resulting in pain and tissue damage; such strains are the most common cause of muscle injuries. The hamstring muscles are particularly susceptible as they cross two joints and regularly perform lengthening contractions during running. We describe a patient with return to full function after a large hamstring tear. Case Description We report the case of a 26-year-old man who presented 1 year after a noncontact, left-sided proximal hamstring tear incurred while sprinting. He received no medical treatment or formal rehabilitation. He was able to return to all sports and activities 1 to 2 months after injury, but noted a persistent deformity of the proximal thigh, which led him to seek evaluation. Physical examination, MRI functional tests, and specific muscle tests 1 year after his injury documented a major hamstring tear at the musculotendinous junction with muscle retraction, but no avulsion of the proximal tendon attachment. Literature Review Surgery often is recommended for major proximal hamstring tendon tears, especially when more than one tendon of origin is ruptured from the ischial tuberosity. Myotendinous tears are treated nonoperatively, but may be associated with decreased strength, prolonged recovery, and recurrence. Purpose and Clinical Relevance We describe the case of a young man who sustained a hamstring tear, with retraction, at the proximal myotendinous junction, where the biceps femoris and semitendinosus arise from the conjoint tendon. He achieved full functional recovery without medical attention, but had a persistent cosmetic deformity and slight hamstring tightness. This case suggests a benign natural history for this injury and the appropriateness of noninvasive treatment.

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Section: Discussionmentioning

confidence: 99%

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

Clark

Henn

Lovering

2011

Clinical Orthopaedics &Amp; Related Research

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“…Imaging may not be necessary in all cases, and a thorough physical examination, including careful palpation, 3 can provide valuable information about the nature of the injury. 8 Nevertheless, imaging not only confirms the diagnosis of muscle injury but also supplies information that helps to predict the time to sport resumption in professional and recreational athletes.…”

Section: Discussionmentioning

confidence: 99%

“…9,14-17 Several groups 5,8,15 compared the performance of sonography and MRI. Among them, a prospective study 14 showed that sonography was as useful as MRI for assessing acute hamstring injury (48 injuries in our study).…”

Section: Discussionmentioning

confidence: 99%

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Value of Sonography Combined With Clinical Assessment to Evaluate Muscle Injury Severity in Athletes

Guillodo

Bouttier

Saraux

2011

Journal of Athletic Training

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Context:Predicting when an athlete can return to sport after muscle injury is a major concern.Objective: To determine whether combining objective clinical and ultrasound findings at presentation accurately predicted time to sport resumption in athletes with muscle injuries.Design: Cohort study. Setting: Sports medicine clinic. Patients or Other Participants: A total of 93 consecutive patients, 87 male and 6 female, were seen over a 1-year period for sudden-onset muscle pain while engaging in a sporting activity within the last 5 days and inability to continue the training session or game. Intervention(s): Standardized physical examination and sonogram.Main Outcome Measure(s): Statistical associations between clinical and sonographic features at presentation and time to sport resumption (<40 days or ≥40 days) were evaluated using multivariate models. Correlations between time to sport resumption predicted by a sports medicine specialist and actual time to sport resumption were evaluated using the Spearman rank correlation coefficient.Results: The 93 patients had 95 injuries, caused by muscle contraction in 86 cases and impact in 9 cases. Only 7 injuries had normal sonogram findings. Late sport resumption was associated with 4 clinical criteria (bruising, tenderness to palpation, range-of-motion limitation compared with the other limb, and increased pain with isometric contraction during passive limb straightening) and 4 sonographic criteria (disorganized fibrous tissue, intramuscular hematoma, intermuscular hematoma, and power Doppler signal). The Spearman rank correlation coefficient between predicted and actual times was 0.669 (P < .0001) for mild exercise resumption and 0.804 (P < .0001) for full sport resumption.Conclusion: A combination of physical and sonographic data collected during the acute phase of sport-related muscle injury was effective in predicting time to sport resumption.Key Words: diagnostic imaging, contusions, strains, sports, return to sport Key Points• Sonography was useful for diagnosing acute sport-related muscle injuries, monitoring the course of the injuries, and guiding the drainage of fluid if needed.• In combination with the objective physical findings, sonographic findings were beneficial in predicting injury severity and time to resumption of sport.

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“…This reduces symptoms of pain, and may improve healing time. It is most frequently performed for contusional injuries of the vasti muscles of the thigh, but has been used anecdotally at other sites, including the hamstrings [57]. Aspiration is ideally performed at about 10 days post injury, when the haematoma is in a stage of liquefaction and can be monitored by serial ultrasound imaging [7].…”

Section: Muscle Tearmentioning

confidence: 99%

Radiological interventions for soft tissue injuries in sport

Campbell

Dunn²

2012

The British Journal of Radiology

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ABSTRACT. Injection therapy has played an integral role in the rehabilitation of sports injuries for many years. The athlete's primary goal is a rapid return to sporting activity. This may be achieved by a combination of either a temporary or permanent reduction in pain, and by a pharmacological or physiological effect that promotes or accelerates a healing response. A wide variety of pharmacological agents are used. However, there is often a lack of good evidence that quantifiable effects can be achieved. There are restrictions on the use of some pharmaceutical agents. This article reviews the various pharmacological agents and bioactive substrates that are available, and discusses the current evidence base of their use in common sports injuries.

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Imaging of hamstring injuries: therapeutic implications

Cited by 72 publications

References 64 publications

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

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

Value of Sonography Combined With Clinical Assessment to Evaluate Muscle Injury Severity in Athletes

Radiological interventions for soft tissue injuries in sport

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