Rhabdomyolysis in DOMS

Summary

A 26-year-old man with a previous history of external twin bursitis was remitted to our Department for a bone scintigraphy. Before the study, the patient performed an elevated number of intense sprints. Bone scintigraphy showed a bilaterally increased activity in both anterior rectum muscles suggesting rhabdomyolysis. Biochemical studies and MRT confirmed the diagnosis.

Zusammenfassung

Ein 26jähriger Mann mit vorausgehender M.-gastrocnemius-Bursitis wurde zur Skelettszintigraphie in unsere Abteilung überwiesen. Vor der Untersuchung führte der Patient mehrere Kurzstreckensprints durch. Die Skelettszintigraphie ergab eine erhöhte Aktivität in beiden Mm. recti femoris, die auf eine Rhabdomyolyse hinweist. Biochemische Untersuchungen und MRT bestätigten die Diagnose.

Key words

Rhabdomyolysis - delayed onset muscle soreness - bone scintigraphy

Schlüsselwörter

Rhabdomyolyse - verzögertes Auftreten von Muskelentzündung - Skelettszintigraphie

• REFERENCES

• 1 Balnave CD, Thompson MW. Effect of training on eccentric exercise-induced muscle damage. J Appl Physiol 1993; 75: 1545-51.
• 2 Smith LL. Acute inflammation: the underlying mechanism in delayed onset muscle soreness?. Med Sei Sports Exerc 1991; 23: 542-51.
• 3 Jones DA, Newham DJ, Round JM, Tolfree EJ. Experimental human muscle damage: morphological changes in relation to other indices of damage. J Physiol 1986; 375: 435-48.
• 4 Talag TS. Residual muscular soreness as influenced by concentric, eccentric, and static contractions. Res Q 1972; 44: 458-69.
• 5 Nurenberg P, Giddings CJ, Stray-Gundersen J, Fleckenstein J, Gonyea W, Peshock R. MR imaging-guided muscle biopsy for correlation of increased signal intensity with ultrastructural change and Delayed Onset Muscle Soreness after exercise. Radiology 1992; 184: 865-9.
• 6 Fleckenstein JL, Weatherall PT, Parkey RW, Payne JA, Peshock RM. Sports-related muscle injuries; evaluation with MR imaging. Radiology 1989; 172: 793-8.
• 7 Shellock FG, Fukanaga T, Mink JH, Edgerton VR. Exertional muscle injury: evaluation of concentric versus eccentric actions with serial MR imaging. Radiology 1991; 179: 659-64.
• 8 Maclntyre DL, Reid D, Lyster DM, Szasz IJ, McKencie DC. Presence of WBC, decreased strength, and delayed soreness in muscle after eccentric exercise. J Appl Physiol 1996; 80: 1006-13.
• 9 Newham DJ, Jones DA, Tolfree SE, Edwards RHT. Skeletal muscle damage: a study of isotope uptake, enzyme efflux and pain after stepping. Eur J Appl Physiol Occup Physiol 1986; 55: 106-12.
• 10 Matin P. Basic principles of Nuclear Medicine techniques for detection and evaluation of trauma and sports medicine injuries. Sem Nucl Med 1988; 18: 90-112.
• 11 Matin P, Lang G, Carreta R. et al. Scintigraphic evaluation of muscle damage following extreme exercise: concise communication. J Nucl Med 1983; 24: 308-11.
• 12 Otsuka N, Fukunaga M, Ono S. et al. Visualization of soft tissue by technetium-99m-MDP in polymyositis. Case reports. Clin Nucl Med 1988; 13: 291-3.
• 13 Huang SJ, Yen DC, Tsau YK, Tsai WS, Chen CH. Rhabdomyolysis syndrome in children: report of three cases. Acta Paediatr Sin 1993; 34: 198-203.
• 14 Aizawa N, Suzuki Y, Akashi T, Kamei T, Uchiyama F, Hara Y. et al. Clinical usefulness of scintigraphy with 99m-technetium phosphates in rhabdomyolysis. Kaku-Igaku 1990; 27: 801-7.
• 15 Mochizuki T, Tauxe WN, Perper JA. Technetium-99m MDP scintigraphy of rhabdomyolysis induced by exertional stroke: a case report. Ann Nucl Med 1990; 4: 111-3.
• 16 Kawamura Y, Waki K, Torigoshi Y, Hirama T, Yoshihara K, Senbo J. et al. A case of rhabdomyolysis demonstrated by Tc-99m methylene diphosphate scintigraphy. Kaku-Igaku 1990; 27: 267-71.
• 17 Bukowski JG, Houet JF, Lepoitevin L, Chapillon M, Delhumeau A. Peroperative rhabdomyolysis caused by compression of a kidney-bridge. Value of muscular scintigraphy. Ann Fr Anesth Reanim 1989; 8: 659-61.
• 18 Créa MS, Rust RJ, Cook DL, Stephens BA. Cocaine-induced rhabdomyolysis. Findings on bone scintigraphy. Clin Nucl Med 1992; 17: 292-3.
• 19 Krause T, Schiimichen C, Hohenloser S, Kasper W, Meinertz T. Scintigraphy using 111-In-labeled antimyosin F(ab)2 monoclonal antibodies and 99m-Tc pyrophosphate in rhabdomyolysis. Nuklearmedizin 1988; 27: 38-9.
• 20 Malik GH, Sirwal IA, Reshi AR, Najar MS, Tanvir M, Altaf M. Acute renal failure following physical torture. Nephron 1993; 63: 434-7.
• 21 Ludmer LM, Chandeysson P, Barth WF. Diphosphonate bone scan in an unusual case of rhabdomyolysis: a report and literature review. J Rheumatol. 1993: 20-2.
• 22 Spies SM, Swift TR, Brown M. Increased 99m-Tc-polyphosphate muscle uptake in a patient with polymyositis. J Nucl Med 1975; 16: 1125-7.