Hamstring Conjoint ​Tendon Complete Rupture

about ultrasound, mri and thermography findings of hamstring conjoint complete tear

Today I show you the clinical case of a professional long-distance runner that felt a moderate pain at the proximal posterior side of his right thigh, after a city marathon. The patient came for first to perform an ultrasound exam.

When the injury involves only the tendinous component, less hematoma can be found, so pay attention when you perform the ultrasound examination; the elastosonography exam can help you, in this case, working like a “contrast agent” better depicting the site of injury.

I suggest you always to perform both MRI and ultrasound exams to establish the real amount of the injury.

And what’s about the thermography examination? A clear asymmetry of the skin temperature is evident in the site of injury, with the right thigh 3.4 °C colder than the left side.

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A Thermographic Evaluation of Patellar​ Tendon Partial Tear

about the thermographic evaluation of patellar tendon degeneration

“Many pathological processes in humans manifest themselves as local changes in heat production and also as changes in blood flow pattern at affected organs or tissues”. Vainer BG. FPA-based infrared thermography as applied to the study of cutaneous perspiration and stimulated a vascular response in humans. Phys Med Biol. 2005 Dec 7;50(23): R63–94. 

Since I met the human thermography I always use this kind of evaluation for diagnosis and monitoring of musculoskeletal diseases, together with all the other imaging modalities.

Today I show you the case of a young athlete practicing long jump, with a chronic patellar tendon tendinopathy and partial tear at its proximal attachment.

I always start with clinical examination and thermographic study.

termography-knee

Thermographic study of the painful right knee

termography knee normal

The thermographic evaluation of the healthy left knee shows a difference of 1,5°C less than the right one

Mri Patellar tendon Tendinopathy

Sagittal T1w – Fusion – Stir Mri of the same patient (0.3 Tesla)

I perform the MRI examination to have also the clear depiction of the cortical patellar bone; as you probably know in many similar cases a bone marrow edema is associated at the inferior pole of the patella.

The study is completed with the dynamic ultrasound exam, both in supine and orthostatic position.

The elastosonography evaluation shows less adaptive changes during the dynamic study, as is usually seen in these pathologic conditions.

I believe in integrated imaging study for musculoskeletal pathologies; thermal cameras are user-friendly for anyone is involved in the diagnosis, monitoring, and treatment of these kinds of pathological conditions.