Exertional rhabdomyolysis of the bilateral adductor magnus

We present a case study of a person (63 year-old man), who has been using statins for 18 years, with rhabdomyolysis of the bilateral adductor muscles associated with strenuous and prolonged eccentric exercises (hiking) in a hot environment. Clinical examination showed predominantly on the right side muscle swelling and palpational pain of the bilateral adductor muscle groups and bilateral tibial edema. His serum creatine kinase (CK) level was 12218 IU/L. T2-weighted magnetic resonance (MR) images showed a high signal intensity in the bilateral adductor muscles of the hip. The patient did not develop complications and returned to his previous performance level in 30 days following adequate hydration and resting of the affected muscles. Strenuous eccentric exercise should be avoided during the course of statin use and clinicians should be aware of present observations when considering the significance of acute CK elevations in patients on statin treatment. Key pointsStatin use can be one of the causes of the rhabdomyolysis following a strenuous eccentric exercise.Elevated CK levels and MRI imaging are important for the diagnosis.The treatment consists of complete rest and adequate hydration.