Department of Orthopedic Surgery, Sheba Medical Center, Tel-Hashomer, Israel.
J Athl Train. 2009 Jan-Feb;44(1):98-100. doi: 10.4085/1062-6050-44.1.98.
Rhabdomyolysis (breakdown of skeletal muscle tissue) may be caused by mechanical, physical, chemical, or biological factors. We present the unique case of a bodybuilder who developed localized rhabdomyolysis of the deltoid muscle after injection of steroids into the shoulder region.
A 39-year-old amateur bodybuilder presented to the emergency department with excruciating pain and inability to move his right shoulder after injecting stanozolol, an anabolic-androgenic steroid (AAS), into his right deltoid muscle on the same day. On physical examination, the right deltoid muscle was swollen and tense and the surrounding skin red, tender, and warm. He had no fluctuation or systemic fever and no sensory or motor deficit. His distal pulsations were distinct. Laboratory test results suggested massive rhabdomyolysis. The major magnetic resonance imaging finding was diffuse hyperintensity signals on T2-weighted images of the deltoid muscle, which was consistent with edema.
Polymyositis and dermatomyositis, mild injury, infectious myositis without phlegmon or abscess formation, radiation therapy, subacute denervation, compartment syndrome, early myositis ossificans, rhabdomyolysis, and sickle cell crisis.
The patient was treated with intravenous fluid replacement and sodium bicarbonate to alkalinize the urine. Four days after admission, his pain had decreased, he had regained range of motion, and his renal function remained unaffected.
Anabolic-androgenic steroid use is associated with various side effects that are generally systemic and dose related. We could not find reports of localized side effects of AAS use, as this case presented, elsewhere in the English-language literature.
"Doping" among amateur athletes occurs frequently. It can cause acute and chronic health problems, most of which are systemic. This is the first description of localized rhabdomyolysis in the area of an AAS injection.
横纹肌溶解症（骨骼肌组织破裂）可能由机械、物理、化学或生物因素引起。我们报告了一个独特的病例，一名健美运动员在肩部注射类固醇后，三角肌发生局部横纹肌溶解症。
一名 39 岁的业余健美运动员在同一天向肩部三角肌注射司坦唑醇（一种合成代谢雄激素类固醇 [AAS]）后，出现剧烈疼痛和无法移动右肩，到急诊就诊。体格检查时，右三角肌肿胀紧张，周围皮肤红肿、触痛且温热。他没有波动热或全身发热，也没有感觉或运动缺陷。他的远端脉搏明显。实验室检查结果提示严重的横纹肌溶解症。主要磁共振成像发现是三角肌 T2 加权图像上弥漫性高信号，符合水肿。
多发性肌炎和皮肌炎、轻度损伤、无脓性或脓肿形成的感染性肌炎、放射治疗、亚急性去神经支配、间隔综合征、早期骨化性肌炎、横纹肌溶解症和镰状细胞危象。
患者接受静脉补液和碳酸氢钠治疗以碱化尿液。入院后第 4 天，他的疼痛减轻，活动范围恢复，肾功能保持正常。
合成代谢雄激素类固醇的使用与各种副作用有关，通常是全身性和剂量相关的。我们在英语文献中没有找到其他地方报告过像这种病例所呈现的 AAS 使用的局部副作用。
业余运动员中“兴奋剂”的使用很常见。它会导致急性和慢性健康问题，其中大多数是全身性的。这是首次描述 AAS 注射部位的局部横纹肌溶解症。
