Sonographic Diagnosis of Rhabdomyolysis

Rhabdomyolysis is the necrosis of skeletal muscle with the release of intracellular substances into the extracellular fluid and circulation, which may cause further life-threatening complications. Early diagnosis and prompt treatment are mandatory. However, the initial clinical manifestations of rhabdomyolysis may be subtle. High suspicion is crucial for early diagnosis. Although definite diagnosis depends on laboratory tests, imaging studies are usually the first modalities used to examine patients. Recently, sonography has been widely used in musculoskeletal disorders; however, few studies mention the sonographic findings of rhabdomyolysis. We report a case of rhabdomyolysis where the characteristic sonographic features are depicted. A 17-year-old male had swelling and pain over the medial side of his left foot after taking part in a 200-meter race. Sonographic examination showed decreased echogenicity, increased thickness, and disorganization of the left abductor hallucis muscle structure. Laboratory tests showed an elevated creatine kinase level of 1,314 U/L. Rhabdomyolysis was diagnosed and the symptoms improved after treatment. We conclude that sonographic examination was useful in diagnosing rhabdomyolysis, leading to further laboratory tests and the proper treatment of this disorder. Sonographic examination is recommended in patients who are clinically suspected of having rhabdomyolysis.