- Note the bone marrow edema within the ischial tuberosity at the hamstring origin. There is a HIGH GRADE PARTIAL AVULSION of the hamstring origin, with resultant retraction and fusiform thickening of the tendons distally.
- Additional areas of edema in the region of the inferior gemellus, gluteus maximus anteriorly, and biceps femoris suggest areas of muscle strain.
Proximal hamstring injury grading:
- Grade 1 - fluid around myotendinous junction without fiber disruption.
- Grade 2 - partial tear.
- Grade 3 - complete disruption
High-grade proximal avulsions can lead to delay in return to sports and long-lasting functional impairments if not treated appropriately, often needing surgical intervention with primary reattachment.
Discussion