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Rhabdomyolysis

Chirag N. Shah, MD, Artika Saharan, MD and Daniel Scott Morrison, Doctor of Medicine Reviewed 05/2023
 


BASICS

DESCRIPTION

  • Breakdown of muscle and release of intracellular contents into the bloodstream.

  • Most commonly caused by traumatic muscle injury.

  • Typically presents with muscle pain, weakness, and redd...

DIAGNOSIS

HISTORY

  • Crush injuries

    • Direct trauma and/or prolonged compression/immobility

      • Motor vehicle accidents (MVA) and entrapment in collapsed buildings. The elderly are more susceptible to crush injur...

TREATMENT

GENERAL MEASURES

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

  • Aggressive hydration with large volumes of IV fluids is often necessary

    • In sever...

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...

REFERENCES

1
Long B, Koyfman A, Gottlieb M. An evidence-based narrative review of the emergency department evaluation and management of rhabdomyolysis. Am J Emerg Med. 2019;37(3):518-523.
2
Stahl K, Rast...

ADDITIONAL READING

  • Cabral BMI, Edding SN, Portocarrero JP, et al. Rhabdomyolysis. Dis Mon. 2020;66(8):101015.

  • Knafl  EG, Hughes  JA, Dimeski  G, et al. Rhabdomyolysis: patterns, c...

SEE ALSO

Algorithm: Acute Kidney Injury (Acute Renal Failure) 

CODES

ICD10

  • M62.82 Rhabdomyolysis

  • T79.6 Traumatic ischemia of muscle

  • T79.6xxS Traumatic ischemia of muscle, sequela

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

  • T79.6xxD Traumatic ischemia of m...

CLINICAL PEARLS

  • Elevation of CK is the diagnostic hallmark of rhabdomyolysis.

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

  • Initial serum creatinine predicts mortali...

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