Hamstring injury - BAC grade 2a and semitendinosus tendon harvest

Case contributed by Henry Knipe
Diagnosis certain

Presentation

Tightness after high speed running 2 days ago. Persistent. Focal lateral hamstring mid-belly tenderness.

Patient Data

Age: 20-25 years
Gender: Male

Feathering T2 hyperintensity involving the anterior myofascial fibers of the long head of biceps muscle belly, 12cm above the knee joint. It measures up to 1.5cm craniocaudally with some slightly more extensive fascial plane fluid interposed between the long and short head of biceps muscle belly. Less than 10% of cross-sectional muscle area involvement. 

Feathering mild increase in T2 signal involving the distal semitendinosus myotendinous muscle fibers, extending over 3.5cm craniocaudally. No hematoma is seen. There is some localized low signal thickening of the semitendinosus tendon at and just below the myotendinous junction. This is in keeping with prior injury/surgery.

Case Discussion

Low grade distal-third long head of biceps tendon strain with classified as BAC grade 2a.

Distal semitendinosus myotendinous junction tendon thickening and adjacent mild muscle T2 hyperintensity, in keeping with post-surgical change (noting the history of prior semitendinosus tendon graft ACL repair). 

Return to play was 1-2 weeks for this player. 

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