MR Imaging of the Distribution and Location of Acute Hamstring Injuries in Athletes
Arthur A. De Smet1 and
Thomas M. Best2
1
Department of Radiology, E3/311, University of Wisconsin Hospital and Clinics,
600 Highland Ave., Madison, WI 53792-3252.
2
Department of Family Medicine and Orthopedic Surgery, University of Wisconsin
Athletic Department, 621 Science Dr., Madison, WI 53711.
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Fig. 1. —Drawing of semitendinosus muscle shows eight sites evaluated for
injury.
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Fig. 2. —Drawing of semitendinosus and long head of biceps shows distribution
of hamstring injuries in 14 of 15 athletes. Injuries occurred within muscles
or at proximal or distal musculotendinous junctions. Fifteenth athlete
sustained isolated proximal junction injury of semimembranosus.
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Fig. 3A. —22-year-old male hurdler with injury at musculotendinous junction in
distal right biceps femoris. Axial spin-echo T1-weighted MR image of distal
thighs shows muscle anatomy of long head (curved arrow) and short
head of right biceps (straight arrow).
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Fig. 3B. —22-year-old male hurdler with injury at musculotendinous junction in
distal right biceps femoris. Axial fast spin-echo T2-weighted MR image with
fat saturation at same level as A shows high signal intensity within
long head (arrow) that surrounds linear low-signal-intensity
tendon.
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Fig. 4. —21-year-old male football defensive lineman with injury at
musculotendinous junction in distal right biceps femoris muscle. Sagittal fast
spin-echo T2-weighted MR image with fat saturation shows high signal intensity
surrounding linear low-signal-intensity tendon (curved arrow) with
dissection along muscle fibers in featherlike pattern.
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Fig. 5A. —20-year-old male sprinter with injury and hematoma at
musculotendinous junction in left biceps femoris muscle just proximal to
origin of short head of biceps femoris. Axial spin-echo T1-weighted MR image
of proximal thighs shows ring of high signal intensity from acute hematoma
(arrowhead) adjacent to intramuscular tendon (small
arrow).
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Fig. 5B. —20-year-old male sprinter with injury and hematoma at
musculotendinous junction in left biceps femoris muscle just proximal to
origin of short head of biceps femoris. Axial fast spin-echo T2-weighted MR
image with fat saturation at same level as A shows mixed high and low
signal intensities within hematoma (arrow).
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Fig. 5C. —20-year-old male sprinter with injury and hematoma at
musculotendinous junction in left biceps femoris muscle just proximal to
origin of short head of biceps femoris. Sagittal fast spin-echo T2-weighted MR
image with fat saturation shows high signal intensity surrounding linear
low-signal-intensity tendon (arrow) and mixed-signal-intensity oval
hematoma.
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Fig. 6A. —22-year-old male long jumper with primary injury of proximal
musculotendinous junction of right biceps femoris and secondary injury of
proximal semitendinosus at intramuscular musculotendinous junction. Axial
spin-echo T1-weighted MR image of proximal thighs shows loss of low signal
intensity around tendon at right proximal musculotendinous junction
(arrow) compared with that of left (arrowhead).
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Fig. 6B. —22-year-old male long jumper with primary injury of proximal
musculotendinous junction of right biceps femoris and secondary injury of
proximal semitendinosus at intramuscular musculotendinous junction. Axial fast
spin-echo T2-weighted MR image with fat saturation at same level as A
shows high signal intensity around tendon (arrow).
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Fig. 6C. —22-year-old male long jumper with primary injury of proximal
musculotendinous junction of right biceps femoris and secondary injury of
proximal semitendinosus at intramuscular musculotendinous junction. Axial fast
spin-echo T2-weighted MR image with fat saturation slightly distal to level of
A and B shows increased signal within biceps (straight
arrow) and semitendinosus (curved arrow). Note prominent rim of
high signal intensity (representing perifascial fluid) around two muscles.
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Fig. 7A. —21-year-old male triple jumper with distal musculotendinous junction
injury of right semitendinosus. Axial spin-echo T1-weighted MR image of distal
thighs shows increased signal at musculotendinous junction of distal
semitendinosus (arrow).
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Fig. 7B. —21-year-old male triple jumper with distal musculotendinous junction
injury of right semitendinosus. Axial fast spin-echo T2-weighted MR image with
fat saturation at same level as A shows high signal intensity at
musculotendinous junction (arrowhead), rim of perifascial fluid
(arrow), and extensive subcutaneous edema or hemorrhage.
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Fig. 8. —22-year-old male triple jumper with proximal musculotendinous injury
of left semimembranosus. Axial fast spin-echo T2-weighted MR image with fat
saturation shows high signal intensity at musculotendinous junction
(arrow) and rim of perifascial fluid.
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