Question

Are there any differential diagnoses issues related to rhabdomyolysis?

Answer 1

Rhabdomyolysis (literally, 'dissolution of skeletal muscle) is a syndrome due to a direct or indirect muscle injury which is results from the death of muscle fibers and release of their contents into the bloodstream. This can lead to serious complications such as renal (kidney) failure, because kidneys cannot remove waste and concentrated urine.

Causes: Crush injury, strenuous exercise,medications, drug abuse

Treatment: Intravenous fluids, dialysis,hemofiltration

Symptoms: Muscle pains, weakness, vomiting,confusion, colored urine

Differential diagnosis:

1.Myocardial infarction- Differentiating sign or symptom is Presence of typical history of substernal chest pain with associated risk factors, signs, and symptoms. Differentiating tests are ECG- may have ST segment changes that suggest infarction. In serum CK can be found as MM (muscle), MB (cardiac), and BB (brain) isoenzymes. And the CK-MB greater than 5% of total CK levels suggests a cardiac source.

2. Fibromyalgia

Here widespread body pain with areas of focal tenderness at designated points. Diagnosis made on clinical criteria. But CK is not elevated. 3. Influenza: having Myalgia, along with respiratory tract symptoms, fever, and headache. But CK not elevated unless influenza viral myositis is present. It is very rare and is more likely in children. Culture, serology, or antigen detection immunoassays may be used, but are not sensitive or specific and it should be interpreted with the clinical findings.