title: Muscle mania: the quest for the perfect body.
abstract: We describe the case of a young man with repeated hospital presentations for a variety of symptoms related to excessive bodybuilding and associated behaviours. He presented to our department (radiology) with right arm pain and loss of function. Ultrasound showed complete triceps rupture, rare in young patients and multiple cystic areas within the muscles of the arm. MRI revealed these to be multiple proteinaceous lesions within the muscle bellies and the possibility of self-innoculation was raised by the reporting radiologist. The patient subsequently admitted to injecting coconut oil to improve muscle contour lost secondary to injury. A review of his hospital presentations was then made and revealed further concerning practices performed by the patient to enhance his muscular appearance.
authors.affiliation: London North West Healthcare NHS Trust, London, UK.|Department of Surgery and Cancer, Imperial College London Division of Surgery, London, UK.
authors.forename: Maira
authors.identifier: http://orcid.org/0000-0002-6290-5695
authors.initials: M
authors.lastname: Hameed
authors.affiliation: London North West Healthcare NHS Trust, Ealing Hospital, London, UK.
authors.forename: Ajay
authors.initials: A
authors.lastname: Sahu
authors.affiliation: London North West Healthcare NHS Trust, London, UK.
authors.forename: Maria B
authors.initials: MB
authors.lastname: Johnson
mesh_terms: D000328:Adult; D001132:Arm / Q000473:pathology*; D001828:Body Image / Q000523:psychology*; D002481:Cellulitis / Q000139:chemically induced; D000074263:Coconut Oil; D003617:Dangerous Behavior; D037001:Directive Counseling; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects; D007273:Injections, Intramuscular / Q000009:adverse effects; D007328:Insulin / Q000008:administration & dosage / Q000009:adverse effects; D008279:Magnetic Resonance Imaging; D008297:Male; D018482:Muscle, Skeletal / Q000187:drug effects / Q000293:injuries / Q000473:pathology*; D009133:Muscular Atrophy / Q000139:chemically induced / Q000473:pathology; D010938:Plant Oils / Q000008:administration & dosage* / Q000009:adverse effects*; D045165:Testosterone Congeners / Q000008:administration & dosage / Q000009:adverse effects; D014284:Triiodothyronine / Q000008:administration & dosage / Q000009:adverse effects; D014891:Weight Lifting / Q000523:psychology*
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin; D010938:Plant Oils; D045165:Testosterone Congeners; D014284:Triiodothyronine; D000074263:Coconut Oil