J Korean Soc Radiol.  2019 Nov;80(6):1229-1234. 10.3348/jksr.2019.80.6.1229.

Exercise-Induced Paraspinal Muscle Rhabdomyolysis with Seconary Compartment Syndrome: A Case Report

• Cho SM
• Lee GJ
• Jin YJ
• Kim KH
• Lee KE
• Shim JC
• Hwang DH
• Kim HK

• KMID: 2464919
• DOI: http://doi.org/10.3348/jksr.2019.80.6.1229

Abstract

Lumbar paraspinal compartment syndrome is an uncommon cause of acute lower back pain. It can result from intense physical activity or as a complication of surgery or medication. Lumbar paraspinal compartment syndrome without external trauma is rarely reported in literature. We report a case of compartment syndrome that followed back muscle exercise and caused rhabdomyolysis. MRI findings include bilateral bulging of the paraspinal muscle, hyperintensity on T2-weighted image, and heterogeneous enhancement. Moreover, loss of intramuscular vasculature on a contrast-enhanced CT scan attributed to diagnose compartment syndrome in this case.

MeSH Terms

Back Muscles
Compartment Syndromes*
Low Back Pain
Magnetic Resonance Imaging
Motor Activity
Paraspinal Muscles*
Rhabdomyolysis*
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 MR findings of exercise-induced paraspinal rhadomyolysis with secondary compartment syndrome in a 26-year-old man, complaining acute back pain following vigorous exercise. A. An axial T1-weighted image (TR/TE, 753.5/10.0) shows swollen bilateral paraspinal muscles with bulging contour without definite signal change. B. An axial T2-weighted image (TR/TE, 3500.0/120.0) shows slightly increased intensity at bilateral multifidus and longissimus muscles. C. A coronal T2-weighted image (TR/TE, 3500.0/120.0) demonstrates diffused high-signal intensity along bilateral lumbar paraspinal muscles. D. Axial fat-suppressed T1-weighted image (TR/TE, 400.0/7.4) with gadolinium-enhancement shows involved bilateral paraspinal compartments (outlined by dashed lines). E. Coronal fat-suppressed T1-weighted image (TR/TE, 400.0/7.4) with gadolinium-enhancement shows both hyper- and hypoenhancing regions. Note that normal intramuscular vasculatures (arrows) are not visible in the hypoenhancing area, suggesting tense compactness. TE = echo time, TR = repetition time

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