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      Painful muscle fibrosis following synthol injections in a bodybuilder: a case report

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          Abstract

          Introduction

          Synthol is a site enhancement oil used by bodybuilders to boost the cosmetic appearance of muscles. Here, we describe the case of a patient with severe side effects following repeated intramuscular injections of synthol in his right biceps muscle.

          Case presentation

          A 29-year-old Middle Eastern male bodybuilder, following intramuscular injections of synthol five years ago, presented with painful pressure in his right upper arm. On presentation to our clinic, his muscle appeared disfigured. Magnetic resonance imaging revealed scattered cystic fatty lesions in the muscle. The affected part was surgically removed and histopathology showed inflammatory changes with fibrosis and a so-called Swiss cheese pattern.

          Conclusion

          Synthol injections that are used for the short-term enhancement of muscle appearance by bodybuilders bear the danger of long-term painful muscle fibrosis and disfigurement.

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          Most cited references7

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          Paraffin oil injection in the body: an obsolete and destructive procedure.

          Marina Pierangeli, Alessandro Scalise, Aldo Bertani … (2002)
          Injection of foreign materials, such as paraffin oil, is an old and obsolete procedure. The authors describe previous uses for this procedure that had been used since the 19th century and the treatment of patients affected by such a disease.
          Article 0 comments Cited 20 times – based on 0 reviews     Review now
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            Subcutaneous oleomas induced by self-injection of sesame seed oil for muscle augmentation.

            H R Bruckbauer, U Darsow, W I Worret … (2000)
            This case presentation describes a 48-year-old man who experienced subcutaneous nodules 9 months after self-injection of sesame seed oil into the pectoral area for muscle augmentation. This procedure was reported by our patient to be frequently performed in the body-building and fitness scene. Ultrasound imaging showed multiple, low reflecting round nodular areas of up to 1 cm diameter in both breasts. Excision of a representative nodule revealed a cyst filled with oily material, surrounded by granulomatous tissue. This case report demonstrates an unusual side effect of augmentation measures in body-builders.
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              [The first "fillers", vaseline and paraffin. From miracle to disaster].

              J Glicenstein (2007)
              In 1899, Robert Gersuny, an austrian surgeon from Vienna, injected a mineral oil (vaseline) to correct the absence of a testicle in a patient who was castrated for tuberculous epididymitis. The immediate success of the operation encouraged him to use vaseline as filler for soft tissue defects. The principle of the technique consisted in the injection of a product that becomes semi liquid by heating but it solidifies when it gets colder. It remains stable and inert in the human body. Eckstein used paraffin instead because the melting temperature is too high (65 degrees ) to soften after the injection. The technique provoked enthusiasm. It was used for the cure of palatal and urinary fistulae, hernia but mainly in cosmetic indications: filling of face wrinkles, cheeks, front and breast augmentation as well as the penis and especially nasal defects. Although serious complications were reported, it remained popular for the first 20 years of the 20th century. Unfortunately even with initial good results, secondary or late severe complications appeared due to the dispersion of paraffin. There was formation of nodules, the paraffinomas that were very difficult to remove. The sequelae of paraffin injections were observed for several years.
              Article 0 comments Cited 6 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Med Case Rep
                Journal ID (iso-abbrev): J Med Case Rep
                Title: Journal of Medical Case Reports
                Publisher: BioMed Central
                ISSN (Electronic): 1752-1947
                Publication date Collection: 2012
                Publication date (Electronic): 20 August 2012
                Volume: 6
                Page: 248
                Affiliations
                [1 ]Department of Orthopaedics, University Hospital Marburg, Baldingerstrasse, Marburg 35033, Germany
                [2 ]Department of Neuropathology, University Hospital Marburg, Baldingerstrasse, Marburg 35033, Germany
                [3 ]Department of Radiology, University Hospital Marburg, Baldingerstrasse, Marburg 35033, Germany
                Article
                Publisher ID: 1752-1947-6-248
                DOI: 10.1186/1752-1947-6-248
                PMC ID: 3459719
                PubMed ID: 22905749
                SO-VID: 971b206f-d8a6-41ff-bb87-739c32f6f8e5
                Copyright © Copyright ©2012 Ghandourah et al.; licensee BioMed Central Ltd.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 13 December 2011
                Date accepted : 22 May 2012
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Medicine
                Data availability:
                ScienceOpen disciplines: Medicine

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