Last reviewed:December 2019
Last updated:November  2019

Summary

Definition

History and exam

Key diagnostic factors

  • recent crush injury
  • prolonged immobilization
  • presence of other risk factors
  • muscular pain

Other diagnostic factors

  • general malaise
  • dark urine
  • muscular swelling
  • muscular tenderness
  • diminished peripheral pulse
  • prolonged capillary refill

Risk factors

  • trauma
  • alcohol
  • cocaine
  • amphetamine
  • phencyclidine
  • narcotics
  • diuretics
  • statins
  • salicylate toxicity
  • toxins
  • envenomation
  • inflammatory disorders
  • muscle hypoxia
  • genetic disorders
  • metabolic disorders
  • infection
  • increased body temperature
  • antipsychotics

Diagnostic investigations

1st investigations to order

  • serum creatine kinase (CK) level
  • serum electrolytes
  • renal function
  • liver function
  • CBC
  • coagulation studies
  • urine dipstick
  • urine microscopy
  • myoglobin levels
Full details

Investigations to consider

  • muscle biopsy
  • thyroid-stimulating hormone
  • erythrocyte sedimentation rate
  • antinuclear antibodies
  • toxicology screen
Full details

Treatment algorithm

Contributors

Clinical Professor of Nephrology

University of Pikeville

Kentucky College of Osteopathic Medicine

Pikeville Medical Center

Pikeville

KY

Disclosures

CP is an author of one reference cited in this topic.

Vice Chair

Department of Medicine 

Division of Nephrology

University of Maryland

Charles Regional Medical Center

La Plata

MD

Disclosures

AK declares that he has no competing interests.

Dr Chinmay Patel and Dr Aditya Kadiyala would like to gratefully acknowledge Dr Mark Shapiro, Dr Courtney Sommer, and Dr Robert D. Mathis, previous contributors to this topic.

Peer reviewersVIEW ALL

Chief

Division of Pulmonary and Critical Care Medicine

University of California, Davis

Sacramento

CA

Disclosures

TA declares that he has no competing interests.

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