MRI report 8-5-2016

STUDY: MRI of the pelvis without contrast

CLINICAL HISTORY: Left thigh pain, concern for hamstring tendon tear
reported. Long distance runner, fall approximately 10 weeks ago. No
reported injury.

COMPARISON: None available

TECHNIQUE: Multiplanar, multisequence MRI of the pelvis was performed
without contrast.

FINDINGS:
The left hamstring tendon at its ischial origin is thickened and
demonstrates increased signal intensity on T2-weighted images,
involving both the semimembranosus and conjoined tendon. A fluid
intensity cleft is seen along the tendon origin involving the
majority (greater than 75%) of the conjoined tendon with a 5 mm fluid
gap between the tendon fibers and the ischium. Few of the biceps
femoris and semitendinosus tendon are intact on coronal STIR image 6.
An additional area of partial tearing of the posterior fibers of the
semimembranosus tendon are identified on axial T2 images 16-20 and
sagittal STIR image 15, involving only a small portion of the tendon.
Edema is interposed between the hamstring tendons without localized
hematoma or drainable collection. Mild strain of the semitendinosus
at the myotendinous junction without intramuscular hematoma.

The sciatic nerve just lateral to the partially torn tendons is
edematous, but is intact.

The right hamstring tendons demonstrate tendinosis with low-grade
partial tearing of the conjoined tendon on T2 images 16 through 18
and coronal STIR images 3-6.

Muscles demonstrate normal bulk and no significant fatty infiltration.
The bones maintain anatomic alignment. No fracture or periosteal
reaction. Red marrow changes are seen in the included pelvic bones
and femurs. No evidence of avascular necrosis.
The hip pubic symphysis are unremarkable.

IMPRESSION:

1. Left hamstring origin tendinosis with superimposed high-grade
tear of the conjoined tendon and low-grade tear of the
semimembranosus tendon. Low-grade strain of the semitendinosus muscle
without intramuscular hematoma. No discernible hamstring muscle
atrophy.

2. Right hamstring origin tendinosis with low-grade partial tear of
the tendon.

3. Edematous appearance of the left sciatic nerve, probably reactive
in etiology.

4. Other incidental findings as above.

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