Sonographic appearance of rhabdomyolysis – a systematic review of the literature

Rhabdomyolysis is the process of striated muscle cell lysis, during which proteins and microelements such as myoglobin are released into the bloodstream. It is important to diagnose rhabdomyolysis as soon as possible and start the treatment according to severity, as it is a state that significantly...

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Published inMedical ultrasonography Vol. 1; no. 1; pp. 92 - 96
Main Authors Sein Anand, Łukasz, Kosiak, Wojciech
Format Journal Article
LanguageEnglish
Published Romania Romanian Society of Ultrasonography in Medicine and Biology 01.01.2020
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ISSN1844-4172
2066-8643
DOI10.11152/mu-2285

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Abstract Rhabdomyolysis is the process of striated muscle cell lysis, during which proteins and microelements such as myoglobin are released into the bloodstream. It is important to diagnose rhabdomyolysis as soon as possible and start the treatment according to severity, as it is a state that significantly increases the mortality of the patients. The current gold standard of rhabdomyolysis diagnosis is the creatine kinase plasma concentration test, but it can be also diagnosed with imaging techniques, such as ultrasound (US). This review aims to gather previously published information regarding sonographic appearance of rhabdomyolysis. We searched through PubMed and ScienceDirect databases for studies using designed queries. After the selection process we were left with 13 studies containing a description of US appearance of rhabdomyolysis confirmed with a CK plasma level test. Findings described in the majority of the cases were muscle thickening, ground glass opacity, traits of edema and anechoic areas. Other than these, there were several less often reported findings. As a conclusion, rhabdomyolysis seems to have its own US appearance, but for now it cannot be precisely specified and needs further research for clarification.
AbstractList Rhabdomyolysis is the process of striated muscle cell lysis, during which proteins and microelements such as myoglobin are released into the bloodstream. It is important to diagnose rhabdomyolysis as soon as possible and start the treatment according to severity, as it is a state that significantly increases the mortality of the patients. The current gold standard of rhabdomyolysis diagnosis is the creatine kinase plasma concentration test, but it can be also diagnosed with imaging techniques, such as ultrasound (US). This review aims to gather previously published information regarding sonographic appearance of rhabdomyolysis. We searched through PubMed and ScienceDirect databases for studies using designed queries. After the selection process we were left with 13 studies containing a description of US appearance of rhabdomyolysis confirmed with a CK plasma level test. Findings described in the majority of the cases were muscle thickening, ground glass opacity, traits of edema and anechoic areas. Other than these, there were several less often reported findings. As a conclusion, rhabdomyolysis seems to have its own US appearance, but for now it cannot be precisely specified and needs further research for clarification.
[...]potassium ions released to the bloodstream alongside myoglobin may elevate the serum level and thus be a potential cause for deadly heart arrythmias [6]. Because of the morbidity risk of rhabdomyolysis complications, a rapid diagnosis and treatment introduction is crucial, based mostly on aggressive fluid therapy, or in more severe cases of AKI based on continuous renal replacement therapy (CRRT) [7]. Next, but nonetheless an important factor is the technology which plays a vital role in US. Since the early eighties there has been a rapid growth of quality and frequency of transducers, imaging software and hardware, changing both how and what can be seen, and allowing for lesions smaller than before and hidden under artifacts to be assessed. [...]the introduction of harmonics and cross-beam technology additionally helped with the removal of various artifacts interfering with the examination, and made the image clearer. [...]the method of examination may also influence the image seen on the monitor, and since there were no specified techniques for every published study, it may have caused additional differences in the findings. Because of these reasons, we decided to perform only a systematic review, to serve as an aid and compiled data source for further research on the subject of usage of ultrasound in the diagnosis of rhabdomyolysis.
Author Sein Anand, Łukasz
Kosiak, Wojciech
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Snippet Rhabdomyolysis is the process of striated muscle cell lysis, during which proteins and microelements such as myoglobin are released into the bloodstream. It is...
[...]potassium ions released to the bloodstream alongside myoglobin may elevate the serum level and thus be a potential cause for deadly heart arrythmias [6]....
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StartPage 92
SubjectTerms Diagnosis
Edema
Humans
Keywords
Literature reviews
Magnetic resonance imaging
Myoglobins
Plasma
Rhabdomyolysis
Rhabdomyolysis - diagnostic imaging
Systematic review
Transducers
Ultrasonic imaging
Ultrasonography
Title Sonographic appearance of rhabdomyolysis – a systematic review of the literature
URI https://www.ncbi.nlm.nih.gov/pubmed/32096794
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Volume 1
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