Tc-99m MDP Three-Phase Bone Scintigraphy in Disciplinary Exercise-induced Rhabdomyolysis

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Abstract
Tc-99m MDP bone scintigraphy is useful in clinically suspected rhabdomyolysis as a diagnostic test and as a test to localize and quantify muscular involvement. A 14-year-old boy had myalgia and painful swelling of both thighs after strenuous disciplinary exercise in middle school. He underwent three-phase bone scintigraphy (TPBS) with Tc-99m MDP to identify the origin of his chief symptoms. In the acute stage of rhabdomyolysis, TPBS showed increased perfusion and blood pooling and increased symmetric skeletal MDP uptake in both thighs. Interestingly, the skeletal MDP uptake was more prominent in the abductor muscles than in the adductor muscles. In the recovery stage, the TPBS revealed marked improvement of skeletal MDP uptake, more than improvement of perfusion and blood pooling in both thighs.