Rhabdomyolysis revisited: Detailed analysis of magnetic resonance imaging findings and their correlation with peripheral neuropathy

Jun Ho Kim, Yeo Ju Kim, Sung Hye Koh, Bom Soo Kim, Sun Young Choi, Seong Eun Cho, Joon Ho Song, Chang Hwan Kim, Kyung Hee Lee, Soon Gu Cho

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7 Scopus citations

Abstract

The objective is to evaluate the magnetic resonance imaging (MRI) findings in rhabdomyolysis in detail and determine their correlation with the development of peripheral neuropathy. Magnetic resonance images for 23 patients with confirmed rhabdomyolysis with (n = 11) or without (n = 12) peripheral neuropathy were retrospectively reviewed for the signal intensity on T1- and T2-weighted images, intramuscular hemorrhage, enhancement pattern, shape and margin in the longitudinal plane, edema in the deep fascia and overlying subcutaneous layer, multiplicity, and bilateral limb involvement. The collected data were statistically analyzed and the relationship between the imaging findings and the development of peripheral neuropathy was determined. Abnormal signal intensities on T1- or T2-weighted images were observed for all patients except one. Fourteen patients (60.9%) showed intramuscular hemorrhage. Stippled enhancement (11/23; 47.8%) was the most common enhancement pattern. Nineteen patients (86.4%) showed a well-defined rectangular shape with a ragged margin in the longitudinal plane. The affected muscle volume usually increased (17/23; 73.9%), with edema in the deep fascia and the overlying subcutaneous layer (13/23; 56.5%). Multiplicity within a muscle, compartment, and limb was observed in 7 (31.8%), 18 (81.8%), and 16 (72.7%) patients, respectively. Bilateral involvement was observed in 7 patients (30.4%). Only multiplicity within a compartment showed a statistically significant correlation with peripheral neuropathy development. Common MRI findings in rhabdomyolysis include intramuscular hemorrhage, stippled enhancement, a well-defined rectangular shape with a ragged margin in the longitudinal plane, and multiplicity. Multiplicity within a compartment may be a predictor of the development of peripheral neuropathy.

Original languageEnglish
Article numbere11848
JournalMedicine (United States)
Volume97
Issue number33
DOIs
StatePublished - 1 Aug 2018

Bibliographical note

Funding Information:
Editor: Weisheng Zhang. This work was supported by Inha University Hospital Research Grant. The study sponsor had no involvement in the conduct of the study or in the writing of the article. An appropriate institutional review board approved the study (for studies involving human subjects or animals). The authors have no conflicts of interest to disclose. aDepartment of Radiology, Inha University Hospital, Inha University School of Medicine, Incheon, bDepartment of Radiology, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, cDepartment of Orthopedic Surgery, Inha University Hospital, Incheon, dDepartment of Radiology, Ewha Womans University Medical Center, Seoul, eDepartment of Internal Medicine, fDepartment of Physical and Rehabilitation Medicine, Inha University Hospital, Incheon, South Korea. ∗Correspondence: Yeo Ju Kim, Department of Radiology, Inha University Hospital, Inha University School of Medicine, 27, Inhang-ro, Choong-gu, Incheon 22332, South Korea (e-mail: kimyeojurad@gmail.com). Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. Medicine (2018) 97:33(e11848) Received: 24 December 2017 / Accepted: 18 July 2018 http://dx.doi.org/10.1097/MD.0000000000011848

Publisher Copyright:
Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal.

Keywords

  • MR
  • Neuropathy
  • Rhabdomyolysis

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