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Hamstring Enthesopathy

Hamstring Enthesopathy

Vice President of the Australian Musculoskeletal Imaging group, Dr Phil Lucas Discusses Hamstring Enthesopathy

 Platelet-rich plasma (PRP) injections have been used for well over a decade in many areas of medicine, including surgery for wound healing, dentistry, regenerative medicine and cosmetics. PRP injections are one of the options in the treatment of recalcitrant tendinopathies and as a natural alternative to the treatment of inflammation in arthritic joints.

About The Condition - Hamstring Enthesopathy

Hamstring Enthesopathy is a condition characterised by tissue damage and inflammation of the hamstringtendon origin around the ischial tuberosity causing pain in the buttock, especially exacerbated by sitting for prolonged periods; but also an over use injury typically seen in running, jumping or kicking sports.

It affects patients of all ages and is often seen as an acute on chronic condition. The condition can be detected via X-ray and MRI, and Platelet-Rich Plasma (PRP) injection performed under ultrasound guidance can be a useful treatment for hamstring enthesopathy. 

In treating such conditions, platelet-rich plasma is prepared on site using the patient’s own blood. This preparation is then re-injected into the affected area under ultrasound guidance to ensure accuracy. These platelets release various substances, including autologous growth factors that promote tissue healing.

Concentrating the platelets leads to higher concentrations of the growth factors and more potential to generate repair. PRP has also been shown to promote the formation of the fibrin mesh required for scar formation and in the promotion of the body’s own stem cells to proliferate and differentiate.

In tendinopathies, the process is slow and occurs over a period of months rather than weeks and may require a series of injections separated by 6-8 weeks. The healing may be in the form of collagen seen in scar tissue, rather than regenerating the collagen of tendon. Whatever the regenerated form, the tissue appears to be “more stable” and less likely to continue precipitating the inflammatory episodes of tendinopathy.

There has also been recent good evidence for the use of PRP in osteoarthritis to help reduce pain. It can also be used as an alternative to other treatments we have traditionally used, including corticosteroid and hyaluronic acid preparations (Synvisc). Imaging-guided injections allow accurate placement of the PRP preparation into the joint. Again, a series of injections over time may be required.

PRP has been shown to be safe as it is derived from the patient’s own blood and is not thought to have any carcinogenic potential, risk of rejection or risk of disease transmission. The injection procedure itself carries a small risk of infection.

Celebrating 11 years of excellence in sports imaging for International Day of Radiology

As a sport and exercise physicians we provide expert diagnosis and management of all musculoskeletal injuries for both elite and recreational athletes, young and old or any person suffering injuries that may occur in the home, at work or during everyday activities.

PRP Diagnostic Imaging is a comprehensive Australian imaging facility also celebrating its 11th birthday on International Day of Radiology. We use a range of modalities including MRI, CT, ultrasound, mammography, breast tomosynthesis, cardiac echo and digital x-ray and interventional pain injections including next generation PRP (platelet rich plasma), Gold Standard Blood therapy injection/s using Autologous Conditioned Serum, or ACS. Patients benefit from the 640-slice CT with ultra-fast scanning times and ultra-low CT dose.

Through the experience of our facility as interventional imaging specialists, as well as general sports imaging specialists we are proud to have been imaging providers for the Sydney Olympics, Sydney Roosters, Sydney Swans and NSW Australian Rugby.

Our specialist team at PRP provide expert diagnosis of all musculo-skeletal conditions including the spine, knee, hip, shoulder, wrist and ankle as well as neurological investigations for conditions such as pituitary and acute stroke.

About DR PHIL LUCAS MB BS FRANZCR

Phil trained as an undergraduate at the University of Sydney with residency and radiology training at the Royal North Shore Hospital, Sydney.

He did a fellowship in musculoskeletal radiology at the University of Virginia, USA, 1996. Phil has been a Clinical Lecturer in Sports Medicine Imaging at the University of NSW, an associate lecturer at Sydney University in Radiology and Honorary Radiologist for the NSW Waratahs Super Rugby, Australian Rugby, the Sydney Roosters Rugby League and the Sydney Swans AFL teams. He was Visiting Radiologist at the Sydney Olympics 2000.

Phil is an active member and vice president currently of the Australian Musculoskeletal Imaging group and a member of the North American Society of Skeletal Radiology.

His special interests are in musculoskeletal ultrasound and MRI and image guided injections and procedures.