Complete left common hamstrings origin avulsion and left gracilis muscle tear
Presentation
Acute onset of pain during HIT training to back of left thigh. Unable to continue training.
Patient Data
Complete avulsion of the left common hamstrings origin with hemorrhage within the tendon attachment gap. Additional high grade complete muscular tear of the proximal left gracilis muscle with hemorrhage within the muscular gap.
Minor feathery muscular edema is within the deeper portion of the right gluteus maximus muscle, overlying the right ischial tuberosity and also in the distal right psoas major muscle, in keeping with a low-grade muscle sprains. Small left hip joint effusion.
Quiz
A - right semimembranosus tendon, B - right conjoint tendon, C - pubic symphysis, D - right adductor magnus muscle, E - right adductor brevis muscle.
Annotated study
Annotated studies, the first highlighting the complete absence of the left common hamstring origin tendons due to a complete avulsion. The second identifying the intact right common hamstring origin tendons and their orientation.
Case Discussion
Hamstring injuries can occur at different regions of the hamstring group, which is made up of the biceps femoris, semimembranosus, and semitendinosus muscles and tendons. Complete or partial avulsion injuries of common hamstring origin can occur, and imaging should include the retracted tendon end to measure the distance from its origin to aid with surgical decision making.
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