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Hamstring Muscle Cramp Visualized on Bone Single-Photon Emission Computed Tomography/Computed Tomography Hybrid
Spyridon Tsiouris1, Xanthi Xourgia, Maria Tsironi
1From the Nuclear Medicine Department, University Hospital of Ioannina, Ioannina, Greece.
American Journal of Physical Medicine & Rehabilitation
|February 17, 2022
Summary
Bone-seeking radiotracers can highlight muscle injury, even from simple heat cramps. This case reveals radiotracer uptake in hamstrings due to exertion and dehydration, a novel finding linked to cramping.
Area of Science:
- Nuclear Medicine
- Radiology
- Sports Medicine
Background:
- Bone-seeking radiotracers are utilized for skeletal imaging.
- Extraskeletal uptake of these tracers in muscles is a known phenomenon, often associated with injury or strenuous activity.
Observation:
- A 50-year-old male patient undergoing bone scintigraphy for prostate cancer staging presented with unexpected bilateral hamstring radiotracer uptake.
- Hybrid scintitomography confirmed the uptake in the semitendinosus muscles.
Findings:
- The patient reported experiencing bilateral hamstring cramps during intense physical activity in warm conditions, potentially exacerbated by dehydration.
- This led to minor, self-limiting rhabdomyolysis, identified incidentally on the bone scan.
Implications:
- This case is the first to report radiotracer absorption in muscles secondary to cramping.
- It highlights the importance of correlating imaging findings with patient history, especially in cases of unexpected extraskeletal uptake.
- It expands the known causes of muscle radiotracer localization beyond direct trauma or strenuous exercise to include cramping-induced muscle damage.
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