Magnetic Resonance Imaging With a Novel Hip Flexion Scanning Position for Diagnosing Proximal Hamstring Tendinopathy

Area of Science:

• Radiology
• Orthopedics
• Sports Medicine

Background:

• Diagnosing proximal hamstring tendinopathy (PHT) can be difficult due to subtle or absent findings on standard MRI scans.
• Patients often present with symptoms that do not correlate with initial imaging results, complicating diagnosis.

Purpose of the Study:

• To evaluate the effectiveness of a novel hip flexion (HF) scanning position for improving MRI diagnosis of PHT.
• To determine if the HF position, simulating sitting, offers greater accuracy than standard MRI views.

Main Methods:

• A cohort of 38 patients with chronic PHT symptoms (>3 months) underwent MRI.
• Two MRI scans were performed: standard supine pelvic examination and a novel side-lying HF position (90° hip flexion).
• Musculoskeletal radiologists independently assessed semimembranosus and biceps femoris tendons for tendinosis or rupture.

Main Results:

• The HF position revealed more severe injury in 71% of patients compared to the standard position.
• Ruptures were identified in 16% of tendons on HF scans that appeared as tendinosis on standard scans.
• In tendons with normal standard MRI findings, 6% showed rupture and 11% showed tendinosis on HF scans.

Conclusions:

• The novel HF MRI scanning position provides significant added value for diagnosing PHT in symptomatic individuals.
• This technique enhances PHT diagnostics, particularly for athletes or active patients with gluteal pain and inconclusive standard MRI results.