Bilateral brachial rhabdomyolysis caused by push-up exercise

Description

A 15-year-old girl presented with an increased swelling bilaterally of her upper arms. Six days before presentation, she performed 50 push-up exercises for the first time in her life. On clinical examination, there was a slight pain and limited range of motion of the shoulder and elbow due to severe swelling of her upper extremity. MRI on T2-weighted sequences showed an increased signal intensity of the medial and lateral heads bilaterally of the triceps brachii, whereas the long heads were intact (figures 1 and 2). Laboratory testing showed elevated creatine kinase (CK) level of 6616 mU/mL and no myoglobinuria. She was diagnosed with rhabdomyolysis and soon admitted for rest and treated by hydration with saline. After 7 days, swelling of her upper arm improved with full range of motion and normal CK level.

Figure 1

Increased signal intensity bilaterally on axial views of the...

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