Reason: low back and buttock pain and Lt leg pain for 3-4 weeks History: as above Evaluation is limited by patient motion artifact. Evaluation of the hamstring tendon origins is limited due to patient motion artifact, however, the proximal end of the conjoined tendon on the left is indistinct and may be avulsed from the ischium. The semimembranosus tendon appears intact at its origin. The sacrotuberous ligament likewise appears intact. There is a small quantity of fluid situated between the ischium and hamstring tendons which could reflect the sequela of a hamstring tear or a bursitis. There is a small amount of fluid and enhancement also noted tracking posteriorly and laterally supporting a bursitis. The relatively mild nature of the edema adjacent to the hamstring tendons suggests that this process may be chronic in etiology. There is mild edema and enhancement between the ischium and lesser trochanter on the left which may represent inflammation due to the aforementioned process or potentially a ischiofemoral impingement, although the ischiofemoral interval does not appear particularly narrowed. There is also a small amount of fluid adjacent to the right hamstring tendons at their origin that may represent a combination of partial-thickness tearing and a bursitis. Mild peritrochanteric edema and enhancement on the left is not necessarily of any current clinical significance. The bone marrow signal intensity of the pelvis and proximal femora is normal. Please refer to the lumbar spine MRI report regarding the degenerative changes of the lumbar spine. There is a small amount of fluid within the right hip, but no frank joint effusion.
1. Limited examination due to patient motion artifact. There is fluid adjacent to the hamstring tendons at their origin, left greater than right, which likely represents a combination of bursitis and partial-thickness tearing with possible avulsion of the left conjoined tendon from the left ischium. We are uncertain, however, if these findings, which may be chronic, are responsible for the patient's pain.2. Degenerative disc disease of the lumbar spine. Please refer to the dedicated MRI lumbar spine report for additional details.