Diagnostic accuracy of ultrasonography for the evaluation of proximal hamstring injuries

To determine the diagnostic accuracy of ultrasonography (USG) for the evaluation of proximal hamstring injury.

A cross-sectional observational study was carried out in the Department of Radiodiagnosis and Interventional Radiology in a tertiary care centre, over a period of 18 months. Patients (20-50 years age) with clinical suspicion of proximal hamstring injury were included, after subjecting them to the selection criteria. Ultrasonography was performed using the 9-12 and 12-18 MHZ linear transducers on Siemens S-3000 machine, while MR imaging was done on 3 Tesla GE Discovery machine.

Fifty patients (M:F = 33:17) were included in the study. Ultrasonography detected proximal hamstring injuries in 34 (68%) participants, consistent with magnetic resonance imaging (MRI) findings. Tendinopathy emerged as the most prevalent diagnosis (42%), followed by isolated tears (14%) and combined tendinopathy and tears (12%). USG demonstrated a sensitivity of 91.2% and a specificity of 81.2%, with an overall diagnostic accuracy of 88%. The positive predictive value and negative predictive value were 91.2% and 81.2%, respectively. A Cohen's Kappa coefficient of 0.724 indicated substantial agreement between USG and MRI findings.

Ultrasonography is a reliable and cost-effective diagnostic tool for proximal hamstring injuries, demonstrating high concordance with MRI. Its integration into clinical practice has the potential to improve accessibility and expedite diagnosis while reducing healthcare costs.

In our study, high diagnostic accuracy was obtained through a combination of clinical and USG examination, therefore, USG can be used as a first line investigative modality for suspected Hamstring injury.