Evaluation of the hamstring muscle complex following acute injury
Evaluation of the hamstring muscle complex following acute injury
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DOI：
10.1007/s00256-003-0674-5
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发表时间：
2003-10-01
影响因子：
2.1
通讯作者：
Connell, D
中科院分区：
文献类型：
--
作者：
Koulouris, G;Connell, D
Objective.探讨急性腘绳肌损伤的影像学表现。设计与患者我们回顾性分析了3年来170例转介到我们机构的腘绳肌复合体（HMC）拉伤患者的影像学表现。在170名患者（154名男性，16名女性，平均年龄28.2岁）中，共发现179处HMC损伤。平均症状持续时间为4.7天（范围1-10天）。97例患者进行了MR成像，102例患者进行了超声检查（20例患者进行了两种检查）。注意肌肉受累的频率、肌肉-肌腱单元内损伤的位置、损伤的程度以及撕脱与肌肉损伤的区别。结果和结论。21例患者近端肌腱损伤，16例撕脱和5例部分撕裂。其中16例患者经手术证实为坐骨结节处腘绳肌撕脱（14例联合，2例仅股二头肌），所有患者均通过MR成像（16/16）进行了可靠诊断，但超声检查（7/12）的诊断率较低。还观察到4例远端肌腱撕脱（3例半腱肌，1例股二头肌）。在肌肉损伤方面，股二头肌最常见（124/154）。半膜肌损伤少见（21/154），半腱肌损伤少见（9/154）。影像学检查可以区分腘绳肌腱撕脱和肌腱拉伤，并有助于确定哪些患者需要手术治疗，而不是保守治疗。
Objective. To evaluate the imaging findings following acute hamstring injury. Design and patients. We retrospectively reviewed the imaging findings of hamstring muscle complex (HMC) strain in 170 patients referred to our institution over a 3-year period. A total of 179 injuries to the HMC were demonstrated in 170 patients (154 male, 16 female, mean age 28.2 years). The mean duration of symptoms was 4.7 days (range 1-10 days). MR imaging was performed in 97 cases and sonography in 102 cases (both modalities were performed in 20 examinations). Attention was directed to the frequency of muscle involvement, the location of the injury within the muscle-tendon unit, the extent of the injury and discriminating avulsion from muscle injury. Results and conclusions. Twenty-one patients had proximal tendon injury, with sixteen avulsions and five partial tears. Sixteen of these patients had surgical confirmation of hamstring avulsion from the ischial tuberosity (14 conjoint, 2 biceps femoris alone) and all were reliably diagnosed with MR imaging (16/16), but less so with sonography (7/12). Four distal tendon avulsions were also observed (three semitendinosus, one biceps femoris). With respect to muscle injury, the biceps femoris was most commonly injured (124/154). Semimembranosus was an uncommon muscle injury (21/154) and semitendinosus rare (9/154). Imaging can discriminate a hamstring tendon avulsion from musculotendinous strain and helps identify which patients necessitate surgical management as opposed to conservative treatment.