Name the muscle, the site (myofascial, myotendinous, intratendinous) and the extent — the British Athletics Muscle Injury Classification grades it, and intratendinous (c) injuries take longest to return to play.
Orient first
- BAMIC grades 0–4 with a suffix a (myofascial), b (musculotendinous), c (intratendinous) (verify scheme).
- Hamstring (biceps femoris long head), rectus femoris and calf injuries are commonest.
- Proximal hamstring avulsion with retraction > 2 cm may need surgery.
Acquire the study
- Axial and coronal STIR/PD fat-saturated, T1; large FOV to include the origin.
The manoeuvre
- Muscle and site on axial images: myofascial, musculotendinous junction, intratendinous.
- Craniocaudal length of oedema in cm; cross-sectional area in %.
- Tendon: intact, partial, complete with retraction in cm.
- Haematoma and its volume.
What confirms it
- MRI-graded injury with site and extent.
What licenses you to exclude it
- No oedema on MRI within days of the event excludes a structural muscle injury.
The classic misread
- Missing a proximal hamstring avulsion by starting the scan below the ischium.