ABSTRACT
The hamstring muscles, located in the posterior thigh, include the biceps femoris,
the semimembranosus, and the semitendinosus. The proximal portions of the hamstring
muscles are subject to a variety of injuries and pathology. Many of these entities
affect the origin of the hamstrings, including the tendinous enthesis, the underlying
ischial tuberosity, and the surrounding tissues. Tendinosis and small partial tears
at the origin are the result of chronic attrition. They may be accompanied by bursitis
or hamstring syndrome. Apophysitis occurs in teenagers prior to complete fusion of
the ischial apophysis and results from repeated traction injuries on the apophysis
without discrete displacement. Abrupt injury at the origin from forced flexion of
the hip results in osseous avulsions of the apophysis in teenagers and proximal tendon
ruptures in adults. Other entities affect the muscles distal to the tendon origins.
These injuries include strains and partial tears of the musculotendinous junction
from acute indirect trauma, delayed onset muscle soreness from overuse of the muscle
group without discrete remembered injury, and contusions and myositis ossificans from
direct blunt impact. The imaging features of these injuries and pathology are fairly
specific and diagnostic, with the exception of some cases of myositis ossificans and
chronic ischial avulsions.
KEYWORDS
Hamstrings - semimembranosus - semitendinosus - biceps femoris - muscle injury - pelvis
- magnetic resonance imaging
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Kirkland W DavisM.D.
Department of Radiology, University of Wisconsin School of Medicine and Public Health
E3/311 Clinical Science Center, 600 Highland Ave., Madison, WI 53792-3252
eMail: kdavis@uwhealth.org
