Spontaneous Pneumomediastinum in an Adolescent with Muscle Dysmorphia

Muscle dysmorphia, a form of Body Dysmorphic Disorder, is marked by an intense preoccupation with muscle size and body image, often leading to excessive physical activity, restrictive eating habits, and the misuse of dietary supplements. We report the case of a 16-year-old boy with muscle dysmorphia who presented to the emergency department with sudden-onset chest pain and was diagnosed with pneumomediastinum. Etiology was attributed to elevated intrathoracic pressure during strenuous weightlifting exercises, combined with dietary restrictions that may have weakened the alveolar walls. This case is the first to document pneumomediastinum associated with muscle dysmorphia, highlighting the risks posed by excessive exercise and rigid dietary behaviors. By sharing this report, we aim to raise awareness among healthcare providers about the potential for rare medical complications in muscle dysmorphia, emphasizing early recognition and intervention to prevent adverse outcomes.