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Rhabdomyolysis and crush syndrome

Last updated: February 2, 2021

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Rhabdomyolysis is the breakdown of skeletal muscle tissue caused by either traumatic or nontraumatic injury (e.g., seizures, ischemia, drug reactions). Traumatic rhabdomyolysis is often due to a crush injury resulting from a prolonged crushing force on skeletal muscle, for example, after being trapped under a collapsed building or following a car accident. Symptoms may be caused by an overabundance of intracellular substances (e.g., myoglobin, potassium, phosphate) following their release from destroyed muscle cells or by third spacing. Rhabdomyolysis classically presents with myalgia, generalized weakness, and darkened urine (myoglobinuria). Complications include acute kidney injury and crush syndrome, the systemic manifestation of traumatic rhabdomyolysis. Crush syndrome is also often associated with acute kidney injury; additionally, it typically presents with signs of volume depletion (hypovolemia, shock) and compartment syndrome of the affected extremity (usually the lower legs). Treatment is generally conservative and includes fluid resuscitation and correction of metabolic abnormalities. In the case of renal failure, dialysis may be indicated.

Causes of rhabdomyolysis

Rhabdomyolysis

Crush syndrome [3]

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  2. Genthon A, Wilcox SR. Crush syndrome: a case report and review of the literature. J Emerg Med. 2014; 46 (2): p.313-319. doi: 10.1016/j.jemermed.2013.08.052 . | Open in Read by QxMD
  3. Crush Injury and Crush Syndrome. https://www.acep.org/MobileArticle.aspx?id=46079&parentid=740. Updated: June 1, 2009. Accessed: February 5, 2017.
  4. Bosch X, Poch E, Grau JM. Rhabdomyolysis and Acute Kidney Injury. N Engl J Med. 2009; 361 (1): p.62-72. doi: 10.1056/nejmra0801327 . | Open in Read by QxMD
  5. Chatzizisis YS, Misirli G, Hatzitolios AI, Giannoglou GD. The syndrome of rhabdomyolysis: Complications and treatment. Eur J Intern Med. 2008; 19 (8): p.568-574. doi: 10.1016/j.ejim.2007.06.037 . | Open in Read by QxMD