Patient History: 64-yo male with right hip pain after doing the splits
Findings
SKELETAL: No macrofracture. No infiltrative or destructive bone lesion.
PELVIS: Not included.
JOINTS: Mild symphysis pubis arthrosis. The hip joint is not entirely included.
ACETABULUM/LABRUM: Not included.
MUSCLES/TENDONS/LIGAMENTS: Complete avulsion of the semimembranosus and conjoined tendon from the ischial tuberosity, without avulsion fracture. A 5-10 mm fluid gap between the ischial tuberosity and hamstring tendons compatible with mild distal distraction. Mild lateral displacement of the hamstring origins relative to the ischium.
Mild soft tissue swelling extends into the hamstring musculature to the mid thigh.
Fluid collection adjacent to the ischium and ruptured hamstrings, 4.2 x 3.4 cm, with increased T1 signal compatible with hematoma.
OTHER/SOFT TISSUE: The anterior muscular compartment is normal. Small bilateral scrotal hydroceles. The anterior thigh is normal. No compartment syndrome. Thickened urinary bladder and suggestion of prostate enlargement with protrusion into the bladder.
Conclusion
1. Complete rupture of the hamstring musculature from the ischium, involving all three hamstring muscles, with 5-10 mm of distal and lateral distraction, soft tissue swelling, 4.2 x 3.4 cm hematoma, and diffuse grade 1 strain of the hamstring musculature. No avulsion fracture.
2. Mild symphysis pubis arthrosis.
