Semimembranosus Muscle Injuries In Sport. A Practical MRI use for Prognosis

Abstract

The aim of this work was to study semimembranosus musculotendinous injuries (SMMTI) and return to play (RTP). The hypothesis is that some related anatomic variables of the SM could contribute to the prognosis of RTP. The retrospective study was done with 19 athletes who suffered SMMTI from 2010 to 2013 and in whose cases a 3.0T MRI was performed. We evaluated the A, B, C SM regions damaged and calculated the relative length and percentage of cross-sectional area (CSA) affected. We found the correlation of these variables with RTP. The data was regrouped in those cases where the part C of the injury was of interest and those in which the C region was unscathed (pooled parts). We used the Mann-Whitney U test and there was a higher RTP when the injury involved the C part of SM (49.1 days; 95% CI [27.6– 70.6]) compared to non-C-part involvement (27.8 days; 95% CI [19.5–36.0]). The SMMTI with longer RTP typically involves the C part with or without participation of the B part. In daily practice, the appearance on MRI of an altered proximal tendon of the SM indicates that the injury affects the C region and therefore has a longer RTP.

Sports-related lower limb muscle injuries: pattern recognition approach and MRI review

“…Clinically, it is sometimes difficult to precisely locate the lesion, and in these circumstances MRI plays a key role. Knowledge of some anatomical characteristics of the distribution of connective tissue and the orientation of fascicles/fibers in these muscle groups [13][14][15][16][17][18][19][20] is crucial for accurately interpreting the MRI findings in the diagnosis of muscle injuries of the lower limbs.…”

“…Although the proximal tendon anatomy is complex and there may be common components to the tendon origins, the adductor longus is the most frequently injured of the three. Adductor longus is a fan-shaped muscle, which arises from the anterior aspect of the pubis just inferior to the pubic tubercle and expands to attach to the middle third of the linea aspera of the femur [18,20]. The proximal tendon is short and conforms an intramuscular aponeurosis.…”

“…The proximal tendon is short and conforms an intramuscular aponeurosis. The most frequent tears of the adductor longus are tears of the proximal tendon (including tendon avulsions) or intramuscular midsubstance tears [18,20]. Distal adductor longus tendon tears are exceedingly rare [18].…”

“…The most frequent tears of the adductor longus are tears of the proximal tendon (including tendon avulsions) or intramuscular midsubstance tears [18,20]. Distal adductor longus tendon tears are exceedingly rare [18]. On the other hand, the adductor magnus has fibers very close to the hamstring/ischial muscles so that proximal lesions are difficult to identify clinically.…”

Hamstrings Injuries with MRI Findings in a Major League Soccer Team

“…Slavotenik et al, found an 87% (26 out of 30 elite soccer players) incidence rate for injuries to the LHBF, and 17% (5 out of 30 cases) to the short head of the biceps [3]. Interestingly, injuries affecting the BF have been associated with faster recoveries than those involving the SM [6,19]. Anatomical features have been previously described and could justify the difference in prevalence of injury between the muscles of the hamstrings complex [4,6,7,20,21].…”