Ultrasound Features of the Proximal Hamstring Muscle‐Tendon‐Bone Unit

Abstract

The hamstring muscle complex is made by a group of posterior biarticular thigh muscles, originating at the ischial tuberosity, which extend the hip and flex the knee joint. Proximal hamstring injuries are frequent among athletes, commonly involving their long myotendinous junction during an eccentric contraction. In this pictorial essay, we describe the ultrasound technique to visualize the normal anatomy of the proximal hamstring muscle‐tendon‐bone complex and present ultrasound findings in patients with traumatic injuries and tendinopathies.

EURO-MUSCULUS/USPRM Dynamic Ultrasound Protocols for (Adult) Hip

“…Ultrasound findings of the tear are alterations of the muscle structure and/or hypo/anechoic hematoma. Complete tear with muscle retraction can be confirmed with dynamic examination under isometric contraction (flexion of the knee against resistance) 47 . Opening the gap within the injured tendon/muscle fibers can be observed.…”

“…Complete tear with muscle retraction can be confirmed with dynamic examination under isometric contraction (flexion of the knee against resistance). 47 Opening the gap within the injured tendon/muscle fibers can be observed. Noteworthy is also "sonopalpation" to locate the site of maximal tenderness.…”

“…The probe is placed in the long axis of the hamstrings over the ischial tuberosity and the apophysis. Dislocation of the apophysis and the ischial tuberosity can be compared with the other (healthy) side 47,48 …”

“…Dislocation of the apophysis and the ischial tuberosity can be compared with the other (healthy) side. 47,48…”

Shear Wave Elastographic Study of the Myotendinous Junction of the Medial Gastrocnemius

“…Furthermore, changes in MTJ stiffness could expose the tendon and muscle structures to greater mechanical stress and increase the risk of muscle and tendon injury events. The MTJ is a common injury site, as reported from both in vitro 34 and in vivo [35][36][37][38] studies. As reported in a meta-analysis by La Croix et al, 39 predictable link exists between the elastic modulus and tendon strength, and the US evaluation may be able to predict failure properties of tendons on the basis of US measurements of the elastic modulus.…”