The adductor magnus “mini-hamstring”: MRI appearance and potential pitfalls

Broski, Stephen M.; Murthy, Naveen S.; Krych, Aaron J.; Obey, Mitchel R.; Collins, Mark S.

doi:10.1007/s00256-015-2291-5

Cited by 19 publications

(22 citation statements)

References 18 publications

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“…The examination continues with axial caudal US scans. At the distal medial tip of the ischial tuberosity, another tendon originates: the adductor magnus, which also has a wider pubofemoral insertion; because of this anatomy, it is also called the “mini‐hamstring” (Figure B) . Below the ischial tuberosity, the semitendinosus muscle is the first to appear, medially to the conjoint tendon; at this level, the semimembranosus tendon starts to travel medially (Figure C).…”

Section: Ultrasound Anatomymentioning

confidence: 99%

“…At the distal medial tip of the ischial tuberosity, another tendon originates: the adductor magnus, which also has a wider pubofemoral insertion; because of this anatomy, it is also called the "mini-hamstring" ( Figure 1B). 17 Below the ischial tuberosity, the semitendinosus muscle is the first to appear, medially to the conjoint tendon; at this level, the semimembranosus tendon starts to travel medially ( Figure 1C). Caudally, the second muscle to appear is the long head of the biceps femoris; here, a good anatomic landmark, the Cohen triangle, 8 is composed of the aponeurosis of the conjoint tendon, the sciatic nerve, and the semimembranosus tendon ( Figure 3A).…”

Section: Scanning Techniquementioning

confidence: 99%

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Ultrasound Features of the Proximal Hamstring Muscle‐Tendon‐Bone Unit

Becciolini¹,

Bonacchi²,

Bianchi³

2018

J of Ultrasound Medicine

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The hamstring muscle complex is made by a group of posterior biarticular thigh muscles, originating at the ischial tuberosity, which extend the hip and flex the knee joint. Proximal hamstring injuries are frequent among athletes, commonly involving their long myotendinous junction during an eccentric contraction. In this pictorial essay, we describe the ultrasound technique to visualize the normal anatomy of the proximal hamstring muscle‐tendon‐bone complex and present ultrasound findings in patients with traumatic injuries and tendinopathies.

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Section: Ultrasound Anatomymentioning

confidence: 99%

Section: Scanning Techniquementioning

confidence: 99%

Ultrasound Features of the Proximal Hamstring Muscle‐Tendon‐Bone Unit

Becciolini¹,

Bonacchi²,

Bianchi³

2018

J of Ultrasound Medicine

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“…Familiarity with this anatomy may aid surgeons in proper placement of anchors when repairing proximal hamstring injuries. Reprinted with permission from Broski et al 5 …”

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confidence: 99%

“…In a recent study by Broski et al, 5 the ischiocondylar portion of the AM was described as a possible source of diagnostic confusion when imaging complete proximal hamstring avulsion injuries with magnetic resonance imaging (MRI) as it may mimic an intact but attenuated semimembranosus tendon. This is especially true on coronal images where it may appear quite prominent ( Figure 2 ).…”

mentioning

confidence: 99%

“…Because the AM is usually intact in cases of proximal hamstring avulsion, radiologists and surgeons run the risk of misdiagnosing patients with complete proximal hamstring avulsion and an intact AM as having only a partial proximal hamstring avulsion. 5 In addition to appearance on imaging, detailed knowledge of the regional anatomy and precise understanding of individual tendon footprint locations relative to one another may facilitate more accurate anatomic reconstruction in patients undergoing surgical repair. 25 Despite the increasing recognition and expanding literature on proximal hamstring injury repair and reconstruction, there are no prior anatomic studies detailing the gross anatomy of the AM and its relationship to the hamstring muscle complex.…”

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confidence: 99%

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Anatomy of the Adductor Magnus Origin

Obey

Broski

Spinner

et al. 2016

Orthopaedic Journal of Sports Medicine

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Background:The adductor magnus (AM) has historically been a potential source of confusion in patients with suspected proximal hamstring avulsion injuries.Purpose:To investigate the anatomic characteristics of the AM, including its osseous origin, anatomic dimensions, and relationship to the proximal hamstring tendons.Study Design:Descriptive laboratory study.Methods:Dissection of the AM origin was performed in 11 (8 cadavers) fresh-frozen hip-to-foot cadaveric hemipelvis specimens. The gross anatomy and architecture of the proximal hamstring and AM tendons were studied. After dissecting the hamstring tendons away from their origin, the dimension, shape, and orientation of the tendon footprints on the ischial tuberosity were determined.Results:The AM was identified in all cadaveric specimens. The mean tendon thickness (anterior to posterior [AP]) was 5.7 ± 2.9 mm. The mean tendon width (medial to lateral [ML]) was 7.1 ± 2.2 mm. The mean tendon length was 13.1 ± 8.7 cm. The mean footprint height (AP dimension) was 12.1 ± 2.9 mm, and mean footprint width (ML dimension) was 17.3 ± 7.1 mm. The mean distance between the AM footprint and the most medial aspect of the conjoint tendon footprint was 8.5 ± 4.2 mm. Tendon measurements demonstrated a considerable degree of both intra- and interspecimen variability.Conclusion:The AM tendon is consistently present just medial to the conjoint tendon at the ischial tuberosity, representing the lateral-most portion of the AM muscle. This study found wide variation in the dimensional characteristics of the AM tendon between specimens. Its shape and location can mimic the appearance of an intact hamstring (conjoint or semimembranosus) tendon intraoperatively or on diagnostic imaging, potentially misleading surgeons and radiologists. Therefore, detailed knowledge of the AM tendon anatomy, footprint anatomy, and its relationship to the hamstring muscle complex is paramount when planning surgical approach and technique.Clinical Relevance:The reported data may aid surgeons in more accurate recognition, diagnosis, and repair of proximal hamstring avulsion injuries.

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Sonographic Appearance of the Ischiocondylar Origin of the Adductor Magnus

Kruse,

Lachman,

Boettcher

2024

J of Ultrasound Medicine

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The adductor magnus ischiocondylar origin (AM‐IO) tendon has often been described as a third proximal hamstring tendon due to its common origin on the ischial tuberosity as well as similar function. Prior studies have described the magnetic resonance imaging characteristics of the AM‐IO; however, its appearance on ultrasound has not been well‐detailed. The purpose of our study is to describe the sonographic appearance of the AM‐IO and provide a structured scanning protocol for complete evaluation of the tendon.

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The adductor magnus “mini-hamstring”: MRI appearance and potential pitfalls

Cited by 19 publications

References 18 publications

Ultrasound Features of the Proximal Hamstring Muscle‐Tendon‐Bone Unit

Ultrasound Features of the Proximal Hamstring Muscle‐Tendon‐Bone Unit

Anatomy of the Adductor Magnus Origin

Sonographic Appearance of the Ischiocondylar Origin of the Adductor Magnus

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