Rhabdomyolysis can also cause abnormality of electrolytes in the blood. Exertional paraspinal muscle rhabdomyolysis and compartment syndrome: a cause of back pain not to be missed. National Library of Medicine J Emerg Med. Livingston KS, Meehan WP 3rd, Hresko MT, Matheney TH, Shore BJ. Get new journal Tables of Contents sent right to your email inbox, December 2007 - Volume 14 - Issue 6 - p 368-370, Rhabdomyolysis associated with compartment syndrome resulting in acute renal failure, Articles in Google Scholar by Hilary West, Other articles in this journal by Hilary West. 30 mins. The item(s) has been successfully added to ", This article has been saved into your User Account, in the Favorites area, under the new folder. Rhabdomyolysis is a commonly encountered condition, but the etiologies, pathophysiology, and complications of rhabdomyolysis are complex and even for experienced health clinicians a review of these can be useful. Registered users can save articles, searches, and manage email alerts. BACKGROUND Acute exertional compartment syndrome (AECS) is a rare cause of leg pain often associated with a delay in diagnosis and potentially leading to irreversible muscle and nerve damage. 2012 Jun;12(3):335-9. Some of the muscle breakdown products, such as the protein myoglobin, are harmful to the kidneys and may lead to kidney failure. Rhabdomyolysis (literally, “dissolution of skeletal muscle”) is a syndrome caused by injury to skeletal muscle and involves leakage of large quantities of potentially toxic intracellular contents into plasma. [email protected]. Rhabdomyolysis is a condition in which damaged skeletal muscle breaks down rapidly. Accessibility access full text with Ovid®. Measurement of creatine kinase is predictive of the extent of muscle damage and the development of renal failure. -, Archbold H, Wilson L, Barr R. Acute exertional compartment syndrome of the leg. Surgery is required to release the compartment to avoid permanent nerve or muscle damage. He was found to have rhabdomyolysis with evidence of renal insufficiency. Wolters Kluwer Health, Inc. and/or its subsidiaries. MRI is the imaging modality of choice. Bethesda, MD 20894, Copyright When muscles inside the compartment aren’t getting enough blood, they die. Acute pain control challenges with buprenorphine/naloxone therapy in a patient with compartment syndrome secondary to McArdle's disease: a case report and review. [ 5] C This is called compartment syndrome. occurs in 13-50% of patients with rhabdomyolysis, which is the principal cause of their mortality. Published online 2014 Feb 4. doi: 10.5492/wjccm.v3.i1.1 PMCID: PMC4021149 The occurrence of acute compartment syndrome in the absence of trauma or fracture, though rare, can have devastating consequences following delays in treatment. CCS is characterized by pain and disability that subside when the precipitating activity is stopped but that return when the activity is resumed. European Journal of Emergency Medicine14(6):368-370, December 2007. may email you for journal alerts and information, but is committed Prevention and treatment information (HHS). Compartment syndrome has rarely been reported associated with acute rhabdomyolysis. 8600 Rockville Pike January 2008; DOI: 10.1007/978-1-84628-937-8_7. This website uses cookies. INTRODUCTIONRhabdomyolysis is a syndrome characterized by muscle necrosis and the release of intracellular muscle constituents into the circulation. Rhabdomyolysis is a well-known clinical syndrome of muscle injury associated with myoglobinuria, electrolyte abnormalities, and often acute kidney injury (AKI). In addition to ischaemia of several hours' duration, our patient presented another very important 2004;14(2):98–100. He was diagnosed with compartment syndrome and rhabdomyolysis. Epub 2013 May 3. Compartment syndrome may be either a complication of or the inciting cause of rhabdomyolysis. Crush syndrome trauma or rhabdomyolysis may also lead to an acute compartment syndrome. His con… Every year in the United States, it is estimated that rhabdomyolysis affects about 26,000 individuals. Compartment syndrome from the head to neck and rhabdomyolysis were recognized, with extensive swelling of his head and neck, markedly swollen soft tissues and necrosis of multiple muscles revealed by computed tomography, and very high concentrations … Careers. PMC3387368. Curr Opin Pharmacol. Your message has been successfully sent to your colleague. 1997 Dec;13(6):382-5. doi: 10.1097/00006565-199712000-00006. Rhabdomyolysis resulting from prolonged statin use may be precipitated by strenuous physical exertion and result in compartment syndrome requiring a fasciotomy. Exertional compartment syndrome of the thigh: a rare diagnosis and literature review. Please enable scripts and reload this page. You may be trying to access this site from a secured browser on the server. eCollection 2019 Jul. 2019 Jul 8;3(7):e017. 2014 Feb 4; 3(1): 1–7.. Clipboard, Search History, and several other advanced features are temporarily unavailable. Proteinuria may also be seen, due t… His management included emergent fluid resuscitation, fasciotomies, debridement of necrotic muscle from his anterior compartment, and delayed primary closure. Lippincott Journals Subscribers, use your username or email along with your password to log in. Symptoms of acute compartment syndrome can include severe pain, poor pulses, decreased ability to move, numbness, or a pale color of the affected limb. Keywords The pathophysiology involves injury to the myocyte membrane and/or altered energy production that results in increased intracellular calciu … Your account has been temporarily locked due to incorrect sign in attempts and will be automatically unlocked in Please try again soon. Rhabdomyolysis is potentially life-threatening although recovery is excellent with early treatment. World J Crit Care Med. 2017 Apr;75(2):148-152. Compartment syndrome has rarely been reported associated with acute rhabdomyolysis. Results: Rhabdomyolysis has been reported in cases of non-necrotising dermatomyositis. Many of these problems can be prevented with early recognition and treatment! Clin Rheumatol. ATN from rhabdomyolysis is a rare complication of compartment syndrome that requires high suspicion and timely treatment to prevent further nephrotoxicity and the resultant increases in mortality. -. Hohenegger M. Drug induced rhabdomyolysis. Neth J Med. Please try after some time. -, Matava M, Whitesides T, Seiler J, et al. J Orthop Trauma. 2019. compartment syndrome; small vessel thrombosis may cause cellular death with subsequent rhabdomyolysis. Background: Acute exertional rhabdomyolysis has been infrequently reported among adolescents. The authors' aggressive management does have some merit - the MRI findings of muscle edema and clinical findings of supraclavicular fossae being full and tense. Khan FY. Rhabdomyolysis is a syndrome characterized by muscle necrosis and the release of intracellular muscle constituents into the circulation. Symptoms may include muscle pains, weakness, vomiting, and confusion. acute renal failure , anuria , compartment syndrome , myoglobinuria , rhabdomyolysis. (Case report) Vanbrabant P, Moke L, Meersseman W, et al. Determination of the compartment pressure threshold of muscle ischemia in a canine. There are two main types: acute and chronic. Compartment syndrome can develop, with the ischaemic and oedematous muscle raising the intracompartmental pressure potentiating a vicious cycle of continuing ischaemia. The case emphasizes the importance of early recognition of compartment syndrome, as loss of pulses is a very late sign, and the examination of the urine to detect myoglobinuria in rhabdomyolysis. We present a case of a 22-year-old college football player who presented to the emergency department (ED) after a typical leg workout as part of his weight conditioning. After six months of intensive outpatient physical therapy, including the use of blood flow restriction treatments, the patient returned to sports and received a NCAA Division I Football scholarship. Would you like email updates of new search results? This is to report an emergency operation performed on a patient with traumatic rhabdomyolysis and compartment syndrome who developed life-threatening hyperkalemia caused by reperfusion injury after vascular anastomosis. Please enable it to take advantage of the complete set of features! You may search for similar articles that contain these same keywords or you may His management included emergent fluid resuscitation, fasciotomies, debridement of necrotic muscle from his anterior compartment, and delayed primary closure. Registered users can save articles, searches, and manage email alerts. Sanghavi R, Aneman A, Parr M, Dunlop L, Champion D. Systemic capillary leak syndrome associated with compartment syndrome and rhabdomyolysis. Diagnosis of atraumatic cases can be difficult, which is why awareness is equally as important as history and physical examination. He was diagnosed with compartment syndrome and rhabdomyolysis. doi: 10.1016/j.jemermed.2007.10.081. Pediatr Emerg Care. 2009;23(6):433–40. Pediatric nonfracture acute compartment syndrome. Rhabdomyolysis (RML) is defined as muscle damage with dissolution of the skeletal muscle fibre and results in release of potentially toxic intracellular components into the systemic circulation. Rhabdomyolysis is a serious syndrome due to a direct or indirect muscle injury. In August 2010, several high school football players from one team developed rhabdomyolysis and triceps compartment syndrome following an upper arm exercise held in a non-air-conditioned wrestling room. This site needs JavaScript to work properly. Rhabdomyolysis syndrome is a clinical synthesis characterized by myoglobinuria, electrolyte abnormalities, and acute kidney injury resulting from the release of intracellular substances into the circulatory system due to skeletal muscle injury. 2009 Oct;67(9):272-83. CASE REPORT We present the case of a previously healthy, high-level athlete who presented with the acute onset of unilateral anterior leg pain and foot drop the day after a strenuous workout. PMID: 19841484. Exertional rhabdomyolysis is sequela that is occasionally seen after strenuous exercise. -, Hope M, McQueen M. Acute compartment syndrome in the absence of fracture. J Am Acad Orthop Surg Glob Res Rev. For immediate assistance, contact Customer Service: For some authors, rhabdomyolysis, compartment syndrome and crush syndrome represent different forms of the same disease [6]. Rhabdomyolysis: Etiology Compartment syndrome and/or rhabdomyolysis can occur in Crush syndrome. your express consent. Creatine kinase (CK) levels are typically markedly elevated, and muscle pain and myoglobinuria may be present. The definition of rhabdomyolysis is debatable, specifically regarding which level of creatinine kinase (if any) predicts renal injury. COVID-19 is an emerging, rapidly evolving situation. It is most often due to injury, such as fracture, that causes bleeding in a muscle, which then causes increased pressure in the muscle.This pressure increase causes nerve damage due to decreased blood supply. AECS requires prompt diagnosis and surgical intervention to prevent these consequences. Exertional rhabdomyolysis in an adolescent athlete. Orthop Trauma. Symptoms include severe pain, numbness, and decreased range of motion. Clin J Sport Med. Search for Similar Articles There may be tea-colored urine or an irregular heartbeat. J Trauma. Compartment syndrome is most commonly due to trauma such as crush injuries or bone fractures. J Am Acad Orthop Surg Glob Res Rev. Acute Exertional Compartment Syndrome in Young Athletes: A Descriptive Case Series and Review of the Literature. 2013 Aug;14(8):1187-91. doi: 10.1111/pme.12135. A classical triad of symptoms includes muscle pain, prostration and dark pigmented urine. FOIA Privacy, Help J Pediatr Orthop. By continuing to use this website you are giving consent to cookies being used. First described in the victims of crush injury during World War II, it is a final pathway of diverse processes and insults. See this image and copyright information in PMC. For more information, please refer to our Privacy Policy. Log in to view full text. doi: 10.5435/JAAOSGlobal-D-19-00017. All rights reserved. Unable to load your collection due to an error, Unable to load your delegates due to an error. Characterization of the Development of Acute-on-Chronic Exertional Compartment Syndrome A Case Report of Symmetric Compartment Syndromes and Review of the Literature. Authors: Laurie A Tomlinson. All registration fields are required. Chronic compartment syndrome (CCS) is a recurrent syndrome during exercise or work. However, to our knowledge we present the first case of NAM complicated by rhabdomyolysis and multiple limb compartment syndrome. Livingston K, Glotzbecker M, Miller P, et al. The progression to compartment syndrome or renal failure is a rare complication that requires prompt recognition and treatment to prevent morbidity (Giannoglou et al. 2004;18(4):220–24. Wik L, Patterson JM, Oswald AE. Excruciating low back pain after strenuous exertion: beware of lumbar paraspinal compartment syndrome. Early treatment usually means a good prognosis. 2007). Compartment syndrome, rhabdomyolysis, and acute renal failure Compartment syndrome can be defined as an increase in pressure within a closed osseofascial spacel -3 As the pressure within an enclosed space increases, blood flow is compromised to the muscle and nerves within the space, and if hypoxia continues for a prolonged period, permanent damage and loss of function will result. 2018 Feb;34(2):76-80. doi: 10.1097/PEC.0000000000000647. CONCLUSIONS We describe the details of this patient's case and review the literature related to acute exertional compartment syndrome. Field management with intravenous fluids and extrication is crucial in reducing the risk of complications and death. to maintaining your privacy and will not share your personal information without It is most commonly due to physical trauma such as a bone fractur Rhabdomyolysis: a review of the literature. Creatine kinase (CK) levels are typically markedly elevated, and muscle pain and myoglobinuria may be present. The severity of illness ranges from asymptomatic elevations in serum muscle enzymes to life-threatening disease associated with extreme enzyme elevations, electrolyte imbalances, and acute kidney injury. Exertional rhabdomyolysis is sequela that is occasionally seen after strenuous exercise. Pediatr Emerg Care. 2010 Aug;39(2):e93-9. Epub 2008 Jul 2. It results from the death of muscle fibers and release of their contents into the bloodstream. Compartment syndrome describes increased pressure within a muscle compartment of the arm or leg. Rhabdomyolysis is a riddle wrapped in a mystery inside an enigma. Rhabdomyolysis describes the breakdown of striated muscles with the release of intracellular contents and represents a severe muscle injury. The patient If you're not a subscriber, you can: You can read the full text of this article if you: Institutional members Some error has occurred while processing your request. King TW, Lerman OZ, Carter JJ, Warren SM. Acute Exertional Compartment Syndrome of Bilateral Upper Extremities After a Push-up Contest. There have also been reports of rhabdomyolysis and compartment syndrome secondary to viral and statin induced myositis. Department of General Surgery, Kent and Canterbury Hospital, Canterbury, England, UK, Correspondence to Dr Hilary West, MBBS, PhD, CBIOL MIBIOL, MRCS(Ed), Department of General Surgery, Kent and Canterbury Hospital, Canterbury CT1 3NG, UK, Tel: +44 1227 766877; fax: +44 1227 864040; e mail: [email protected], Received 20 October 2006 Accepted 20 January 2007. Complications of rhabdomyolysis are high blood potassium (hyperkalemia), low blood calcium (hypocalcaemia), compartment syndrome, and disseminated intravascular coagulation. International Scientific Literature, Ltd. Bull Hosp Jt Dis (2013). Since no electromyography/nerve conduction studies were done, it would be difficult to attribute the cause to a focal rhabdomyolysis and compartment syndrome. Wolters Kluwer Health Compartment syndrome is a condition in which increased pressure within one of the body's anatomical compartments results in insufficient blood supply to tissue within that space. modify the keyword list to augment your search. but rhabdomyolysis can cause death and serious complications like acute kidney injury and compartment syndrome. McCormick Z, Chu SK, Chang-Chien GC, Joseph P. Pain Med. For information on cookies and how you can disable them visit our Privacy and Cookie Policy. While diagnosis is primarily clinical, it can be supported with direct intra-compartmental pressure measurements and maintaining a high index of suspicion in acute presentations of exertional limb pain. 2016;36(7):685–90. The compartment syndrome is most common after injury in the lower leg, arms, or the muscles of the abdominal wall and can require emergency surgery. There are precisely zero RCTs showing benefit of any treatment for rhabdomyolysis. 2010;29(7):803-805. Tzioupis C, Cox G, Giannoudis P. Acute compartment syndrome of the lower extremity: an update. While not common, if untreated or not treated quickly enough, compartment syndrome can lead to permanent disability as the body cannot replace dead muscle. In the case described, the rhabdomyolysis was severe enough to cause compartment syndrome and acute renal failure after moderate exercise and alcohol intake and had the appearance of a myositis. It is imperative for orthopedic surgeons to be aware of this potential complication. Compartments of the leg or arm are most commonly involved. In the case described, the rhabdomyolysis was severe enough to cause compartment syndrome and acute renal failure after moderate exercise and alcohol intake and had the appearance of a myositis. Data is temporarily unavailable. 1994;37(1):50–58. Like rhabdomyolysis, it can also occur when blood flow returns after a duration of poor blood flow. 800-638-3030 (within USA), 301-223-2300 (international). Rhabdomyolysis and Compartment Syndrome. 800-638-3030 (within USA), 301-223-2300 (international)