Presentation
Bodybuilder with history of intramuscular synthol injection. Now suspected pectoralis muscle tear.
Patient Data
The deltoid, biceps, and triceps muscles are diffusely swollen showing diffuse increased signal onT1 & T2 WI (compared to the adjacent healthy muscles) secondary to injected oil, with scattered cystic fatty clumps within the muscles which represent oil clumps between muscle bundles.
Pectorlais muscle tear at its myotendinous junction with fiber retraction and adjacent fluid signal.
Enlarged right axillary lymph nodes showing a similar signal to the injected muscles.
Case Discussion
Intramuscular oil injections are used for the enhancement of the muscle appearance of bodybuilders. Synthol is one of the materials used for this purpose. Following the injection of oil, muscles undergo rapid muscle enlargement.
On MRI, the injected muscles appear swollen showing a diffuse increased signal on T2 signal with scattered oil cysts within the muscle bundles. On contrast-enhanced fat sat sequences, there's heterogeneous contrast enhancement in case of complicated inflammatory changes.
Complications include inflammatory foreign body reaction, fibrosis with disfigurement and extensive vacuolation.