HAMSTRINGS - ACUTE INJURY MRI Protocol
ROUTINE PROTOCOL
ROUTINE PROTOCOL
Check with patient re: site of suspected tear and mark with oil capsule(s) if appropriate.
Area of interest will be posterior, so spinal coil elements alone are satisfactory. If suspected site of tear is medial/lateral or unsure, add Body Matrix/Large surface coil anteriorly and wrap over ?site of tear for extra signal. Hamstrings insert proximally into the ischial tuberosity and distally into the proximal portions of the tibia/fibulaComplete the following sequences (in order):
Area of interest will be posterior, so spinal coil elements alone are satisfactory. If suspected site of tear is medial/lateral or unsure, add Body Matrix/Large surface coil anteriorly and wrap over ?site of tear for extra signal. Hamstrings insert proximally into the ischial tuberosity and distally into the proximal portions of the tibia/fibulaComplete the following sequences (in order):
- Axial and Long Axis localisers (find oil capsule)
- STIR/T2FS Coronal (Blue lines on Fig’s) - to include tear site + 1 muscle insertion (closest)
- STIR/T2 FS Sagittal (Red lines on Fig’s) - to cover tear site + 1 muscle insertion (closest)
- STIR/T2 FS Axial (Green lines on Fig’s) - cover just the tear (if appropriate) or oil capsule (if no tear seen)
- T1 Sagittal (copied exactly to STIR/T2FS Sagittal)
- T1 Axial (copied exactly to STIR/T2FS Axial)
It is important to note that the desired coverage is entirely user-dependent - ie gauge this from the size of the tear/oedema present or the area of pain reported by the player. If no tear is seen, double-check edge of field of view because tears DO occur some distance from where the player indicates (referred pain). If T2FS was chosen for long axis imaging, be careful because loss of fat suppression is common at the far reaches of the FoV. Repeat sagittals with STIR if in any doubt.
HAMSTRINGS - RECURRENT/TROUBLESOME/NON-ACUTE INJURY MRI Protocol
ROUTINE PROTOCOL
For players complaining of a long history of pain or recurrent injuries, it is important to image the entire hamstrings (from top to bottom) of the affected side. This situation will most commonly arise with proximal insertion pain (ischial tuberosity) - on Coronals try to include both sides for comparison.
ROUTINE PROTOCOL
For players complaining of a long history of pain or recurrent injuries, it is important to image the entire hamstrings (from top to bottom) of the affected side. This situation will most commonly arise with proximal insertion pain (ischial tuberosity) - on Coronals try to include both sides for comparison.
- Follow “Acute Injury” protocol
- Add a STIR/T2FS & T1 sagittal to cover rest of hamstrings, and review.
- Add axials if pathology present.
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