Hamstring injury - BAC grade 2c

Case contributed by Dr Henry Knipe

Presentation

Tightness during Q1 of last week's game. Able to function but has hamstring signs.

Patient Data

Age: 30 years
Gender: Male

Feathering edema involving the myotendinous junction fibers of the long head of biceps femoris, commencing 6cm caudal to the common hamstring origin. It extends over 14cm craniocaudally. <50% of muscle bulk cross-sectional area. Localized redundancy of the aponeurosis/tendon slip of the proximal long head of biceps femoris. More extensive fascial plane fluid tracking caudally.

Lateral peripheral feathering edema involving the semitendinosus proximal muscle belly. Semimembranosus tendon and muscle belly appearances are within normal limits.

Note is made of left intratendinous T2 hyperintensity at the proximal portion of the common tendon of the long head of biceps femoris/semitendinosus.

Case Discussion

Biceps femoris long head and adjacent semitendinosus muscle proximal myotendinous junction injuries. Focal area of intratendinous signal abnormality with localized redundancy of aponeurosis/tendon slip of the long head of biceps femoris.

The BAC classification is grade 2c. Return to play was day 14 post-injury. 

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