Ultrasound detection of hamstrings tears (a less usual case for hip pain)

Min Hui Ho1, Suraj Menon1, Lisa Meacock2, 1Radiology Department, Darent Valley Hospital NHS Trust, 2Imaging Department, Kings College Hospital, NHS Foundation Trust

Purpose/Aim of study:

To demonstrate the value of ultrasound in detecting full thickness and partial thickness tears of the hamstrings attachment on the ischial tuberosities.

To demonstrate the value of ultrasound as an adjunct to guided intervention.

Material and methods:

191(n=191) patients were evaluated for hip pain complaints within a 6 months period in our two hospitals, using ultrasound, by 4 dedicated musculoskeletal radiologists.  112(k1= 112) were female patients and 79(k2=79) were male patients. The age range was between 49 and 91, with a preponderance of patients in their 6th and 7th decades.

The referring diagnosis was in most cases trochanteric bursitis, muscle tears, haematomas or joint effusion.

Several patients were referred with hip pain following hip joint replacements. Post-operative collections or muscle tears were suspected.

Results:

35 patients (r=35) unsuspected tears of the hamstrings.

2 (r1=2) patients were found to have full thickness tears of the hamstrings. Both patients presented following falls after hip replacement surgery.

33 (r2=33) patients presented with unsuspected deep surface partial tears of the hamstrings. Of these patients 7(b=7) had bilateral partial tears of the hamstrings.

Conclusion and study limitations:

Both full thickness and partial thickness tears can be demonstrated with high resolution ultrasound.

Ultrasound evaluation is particularly helpful in the postoperative setting (no artefact as compared to MRI), can be less time-consuming and can guide intervention.

Our study is limited by the small numbers included in the study cohort, and by the limitations of ultrasound in patients with high BMI, in whom studies are difficult to perform.

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