Rhabdomyolysis

Question 1

What is rhabdomyolysis?

Answer 1

A condition where skeletal muscle tissue breaks down and releases breakdown products into the blood, usually triggered by an event that causes the muscle to break down e.g. extreme underuse or overuse or a traumatic injury

Question 2

What are some causes of rhabdomyolysis?

Answer 2

Prolonged immobility (Common after elderly falls)
Extremely rigorous exercise beyond that persons fitness level
Crush injury
Seizures

Question 3

What is released by muscle cells undergoing apoptosis which can cause kidney injury?

Answer 3

• Myoglobin(causingmyoglobinurea)
• Potassium - the most immediately dangerous breakdown product as hyperkalaemia can cause arrhymias
• Phosphate
• Creatine kinase

Question 4

How does rhabdomyolysis present?

Answer 4

• Muscle aches and pain
• Oedema
• Fatigue
• Confusion (particularly in elderly frail patients)
• Red-brown urine

Question 5

What are some investigations required in rhabdomyolysis?

Answer 5

Creatinine kinase
Urinalysis and urine observation
U+Es
ECG - Hyperkalaemia

Question 6

What will be seen in the urine on rhabdomyolysis

Answer 6

Red-brown colour due to myoglobinuria
Positive for blood

Question 7

How is rhabdomyolysis managed?

Answer 7

IV fluids