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Year : 2017  |  Volume : 32  |  Issue : 3  |  Page : 247  

Myofascial pain syndrome on Tc99m MDP bone scintigraphy

Department of Radiology, Salmaniaya Medical Complex, Manama, Kingdom of Bahrain

Date of Web Publication13-Jun-2017

Correspondence Address:
S K Chirala
Department of Radiology, Salmaniaya Medical Complex, PB 12, Manama, 311
Kingdom of Bahrain
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0972-3919.207889

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How to cite this article:
Hussain RA, Ali AM, Manivannan K, Chirala S K. Myofascial pain syndrome on Tc99m MDP bone scintigraphy. Indian J Nucl Med 2017;32:247

How to cite this URL:
Hussain RA, Ali AM, Manivannan K, Chirala S K. Myofascial pain syndrome on Tc99m MDP bone scintigraphy. Indian J Nucl Med [serial online] 2017 [cited 2023 Mar 30];32:247. Available from:


A 45-year-old male presented with upper back pain of 1 month duration. The only relevant finding in the clinical history was that he has been using a computer with a keyboard for extended number of hours each day for years. Chest X-ray posteroanterior view showed soft tissue swelling and calcification in the right axillary region [Figure 1].99m Tc-Methylene Diphosphonate skeletal scintigraphy showed abnormal radiopharmaceutical localization at multiple sites in the skeleton indicating skeletal metastasis. Following computed tomography (CT) of the chest, biopsy of the lung lesion reported adenocarcinoma of lung. In the 99m Tc-MDP skeletal scintigraphy, abnormal soft tissue localization was also seen in the region of the teres major muscles, bilaterally, more on the right side [Figure 2]. Magnetic resonance imaging confirmed this soft tissue process in the right shoulder. These findings were consistent with rhabdomyolysis.
Figure 1: Chest X-ray: soft tissue calcification and swelling (arrow)

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Figure 2: 99mTc-MDP skeletal scintigraphy: skeletal metastasis and soft tissue uptake in Teres major muscles, bilaterally: right > left (arrows)

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Rhabdomyolysis of the Teres muscles appears to be a very rare occurrence, and has been reported as a sports injury [1] after transcatheter chemoembolization,[2] and as an incidental finding.[3] In the present case, rhabdomyolysis of the Teres muscles was seen in the clinical setting of skeletal metastasis in an unknown primary, which was later diagnosed as adenocarcinoma of the lung.

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There are no conflicts of interest.

   References Top

Oza UD, Oates E. Rhabdomyolysis of Bilateral Teres Major Muscles. Clin Nucl Med 2003;28:126-7.  Back to cited text no. 1
K1 Matake, Tajima T, Yoshimitsu K, Irie H, Aibe H, Sugitani A, et al. Rhabdomyolysis developing after Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma, Cardiovasc Intervent Radiol. 2009;32:1284-7.  Back to cited text no. 2
Steuart RD, Morrison RT, Lot L. An Incidental Finding of Rhabdomyolysis on Bone Scintigraphy: Case Report. J Nucl Med Technol 1993;21:63-4.Sir,  Back to cited text no. 3


  [Figure 1], [Figure 2]


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