Christophel Elizabeth, Ladas Cassidy, Patterson Francis, Lelkes Valdis
Hackensack Meridian Health Department of Orthopedic Oncology, 20 Prospect Avenue, Suite 901, Hackensack, NJ 07601, United States of America.
Trauma Case Rep. 2023 Aug 7;47:100887. doi: 10.1016/j.tcr.2023.100887. eCollection 2023 Oct.
Musculoskeletal injuries are a known side effect of long-term statin use. These injuries include sudden, atraumatic muscle rupture which can cause extremity hematomas that motivate patients to seek evaluation and physicians to send referrals for oncologic workup. We discuss two cases where malignancy was suspected rather than statin-induced muscle injury. Using these cases as examples, we discuss subtleties between the two diagnoses so that muscle rupture may be considered prior to subspecialist referral. This paper aims to serve as a reminder and guide for physicians who encounter long-term statin users with nonspecific, improving musculoskeletal symptoms and hemorrhagic MRI findings that lack nodular or mass-like enhancements. While referral to orthopedic oncology is always encouraged in cases of uncertainty, it may not always be necessary.
肌肉骨骼损伤是长期使用他汀类药物已知的副作用。这些损伤包括突然发生的、无创伤性的肌肉破裂,可导致肢体血肿,促使患者寻求评估,也促使医生将患者转诊进行肿瘤学检查。我们讨论两例被怀疑为恶性肿瘤而非他汀类药物引起的肌肉损伤的病例。以这些病例为例,我们讨论这两种诊断之间的细微差别,以便在转诊至专科医生之前考虑肌肉破裂的可能性。本文旨在提醒并指导那些遇到长期使用他汀类药物、出现非特异性、逐渐改善的肌肉骨骼症状以及MRI表现为出血但缺乏结节状或肿块样强化的医生。虽然在不确定的情况下总是鼓励转诊至骨肿瘤学专科,但并非总是必要的。