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Crema MD, Guermazi A, Reurink G, et al. Can a Clinical Examination Demonstrate Intramuscular Tendon Involvement in Acute Hamstring Injuries?. Orthop J Sports Med. 2017;5(10):2325967117733434doi: 10.1177/2325967117733434.
Crema, M. D., Guermazi, A., Reurink, G., Roemer, F. W., Maas, M., Weir, A., Moen, M. H., Goudswaard, G. J., & Tol, J. L. (2017). Can a Clinical Examination Demonstrate Intramuscular Tendon Involvement in Acute Hamstring Injuries?. Orthopaedic journal of sports medicine, 5(10), 2325967117733434. https://doi.org/10.1177/2325967117733434
Crema, Michel D, et al. "Can a Clinical Examination Demonstrate Intramuscular Tendon Involvement in Acute Hamstring Injuries?." Orthopaedic journal of sports medicine vol. 5,10 (2017): 2325967117733434. doi: https://doi.org/10.1177/2325967117733434
Crema MD, Guermazi A, Reurink G, Roemer FW, Maas M, Weir A, Moen MH, Goudswaard GJ, Tol JL. Can a Clinical Examination Demonstrate Intramuscular Tendon Involvement in Acute Hamstring Injuries?. Orthop J Sports Med. 2017 Oct 26;5(10):2325967117733434. doi: 10.1177/2325967117733434. eCollection 2017 Oct. PMID: 29124077; PMCID: PMC5661687.
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Orthop J Sports Med. 2017 Oct 26;5(10):2325967117733434. doi: 10.1177/2325967117733434. eCollection 2017 Oct.

Can a Clinical Examination Demonstrate Intramuscular Tendon Involvement in Acute Hamstring Injuries?.

Orthopaedic journal of sports medicine

Michel D Crema, Ali Guermazi, Gustaaf Reurink, Frank W Roemer, Mario Maas, Adam Weir, Maarten H Moen, Gert J Goudswaard, Johannes L Tol

Affiliations

  1. Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA.
  2. Department of Radiology, Saint-Antoine Hospital, Paris VI University, Paris, France.
  3. Amsterdam Center for Evidence Based Sports Medicine, Academic Medical Center, Amsterdam, the Netherlands.
  4. Department of Radiology, Friedrich-Alexander University of Erlangen-Nüremberg, Erlangen, Germany.
  5. Erasmus MC Center for Groin Injuries, Department of Orthopaedics, Erasmus MC University Medical Centre, Rotterdam, the Netherlands.
  6. Department of Sports Medicine, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
  7. Department of Sports Medicine, Bergman Clinics, Naarden, the Netherlands.

PMID: 29124077 PMCID: PMC5661687 DOI: 10.1177/2325967117733434

Abstract

BACKGROUND: Involvement of the intramuscular (central) tendon in acute hamstring injuries, as detected on magnetic resonance imaging (MRI), may prolong recovery times. To date, it is unclear whether hamstring injuries exhibiting intramuscular tendon involvement can be identified though routine clinical examinations that assess flexibility and strength.

PURPOSE: To test whether MRI-detected intramuscular tendon involvement could be identified by a clinical assessment of muscle strength and flexibility.

STUDY DESIGN: Case-control study; Level of evidence, 3.

METHODS: Participants were drawn from a multicenter randomized controlled trial on the effect of platelet-rich plasma in acute hamstring injuries. Clinical parameters assessed within 5 days of injury were active knee extension and passive straight-leg raise for hamstring flexibility and isometric knee flexion force with 15° and 90° of knee flexion. Also, 1.5-T MRI of the thigh was performed within 5 days of injury and was evaluated for the presence of different types of intramuscular tendon involvement. One-way analysis of variance was used to determine whether clinical parameters could discriminate injuries with intramuscular tendon involvement from those without such involvement.

RESULTS: A total of 74 acute hamstring injuries were included, with 52 (70.3%) injuries affecting the myotendinous junction. Injuries exhibiting intramuscular tendon discontinuity on MRI had an increased mean absolute flexibility deficit for active knee extension (20.4° ± 14.9° vs 10.7° ± 9.0°, respectively;

CONCLUSION: Hamstring flexibility and strength cannot be used to discriminate the presence of intramuscular tendon involvement.

Keywords: hamstring injury; magnetic resonance imaging; muscle flexibility; muscle strength

Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: This study was supported by the Royal Dutch Football Association and Arthrex Medizinische Ins

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