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Rhabdomyolysis

Caroline Tschibelu, MD and Chirag N. Shah, MD, FACEP Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Breakdown of skeletal muscle with systemic release of intracellular contents

  • Rhabdomyolysis typically presents with muscle pain, weakness, and reddish brown (tea-colored) urine. Up to...

DIAGNOSIS

HISTORY

  • Crush injury: direct trauma, prolonged compression/immobility. Causes include motor vehicle accidents (MVA) and entrapment in collapsed buildings. The elderly are more susceptible to ...

TREATMENT

GENERAL MEASURES

  • Address underlying cause (e.g., medications cessation, temperature control, trauma, infection).

  • Aggressive hydration is often necessary. With severe muscle trauma (crush injur...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Follow-up within a few days to recheck CK, electrolytes, and renal function 

Patient Monitoring

  • Contingent on disease: essential for metabolic myopathies

  • Myotoxic dr...

REFERENCES

1
Murphy CM, Dulaney AR, Beuhler MC, et al. “Bath salts” and “plant food” products: the experience of one regional US poison center. J Med Toxicol.  2013;9(1):42–48. [View Abstract on O...

ADDITIONAL READING

  • Durand D, Delgado LL, de la Parra-Pellot DM, et al. Psychosis and severe rhabdomyolysis associated with synthetic cannabinoid use: a case report. Clin Schizophr Relat Psychoses. ...

CODES

ICD10

  • M62.82 Rhabdomyolysis

  • T79.6XXA Traumatic ischemia of muscle, initial encounter

  • T79.6XXD Traumatic ischemia of muscle, subsequent encounter

  • T79.6XXS Traumatic ischemia of muscle, sequela

ICD9

728...

CLINICAL PEARLS

  • Elevation of CK is the diagnostic hallmark of rhabdomyolysis.

  • The cornerstone of treatment of rhabdomyolysis is aggressive fluid administration.

  • Electrolyte abnormalities, acute kidney i...

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