rhabdomyolysis compartment syndrome
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. 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. 2007). Creatine kinase (CK) levels are typically markedly elevated, and muscle pain and myoglobinuria may be present. 800-638-3030 (within USA), 301-223-2300 (international). Careers. J Emerg Med. doi: 10.1016/j.jemermed.2007.10.081. Wik L, Patterson JM, Oswald AE. 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. MRI is the imaging modality of choice. However, to our knowledge we present the first case of NAM complicated by rhabdomyolysis and multiple limb compartment syndrome. He was diagnosed with compartment syndrome and rhabdomyolysis. AECS requires prompt diagnosis and surgical intervention to prevent these consequences. eCollection 2019 Jul. 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. Compartment syndrome has rarely been reported associated with acute rhabdomyolysis. Published online 2014 Feb 4. doi: 10.5492/wjccm.v3.i1.1 PMCID: PMC4021149 Livingston KS, Meehan WP 3rd, Hresko MT, Matheney TH, Shore BJ. -, Archbold H, Wilson L, Barr R. Acute exertional compartment syndrome of the leg. When muscles inside the compartment aren’t getting enough blood, they die. COVID-19 is an emerging, rapidly evolving situation. The definition of rhabdomyolysis is debatable, specifically regarding which level of creatinine kinase (if any) predicts renal injury. Data is temporarily unavailable. but rhabdomyolysis can cause death and serious complications like acute kidney injury and 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. See this image and copyright information in PMC. Registered users can save articles, searches, and manage email alerts. By continuing to use this website you are giving consent to cookies being used. INTRODUCTIONRhabdomyolysis is a syndrome characterized by muscle necrosis and the release of intracellular muscle constituents into the circulation. Please enable it to take advantage of the complete set of features! Determination of the compartment pressure threshold of muscle ischemia in a canine. Every year in the United States, it is estimated that rhabdomyolysis affects about 26,000 individuals. 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. Early treatment usually means a good prognosis. 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. The progression to compartment syndrome or renal failure is a rare complication that requires prompt recognition and treatment to prevent morbidity (Giannoglou et al. doi: 10.5435/JAAOSGlobal-D-19-00017. For more information, please refer to our Privacy Policy. European Journal of Emergency Medicine14(6):368-370, December 2007. Measurement of creatine kinase is predictive of the extent of muscle damage and the development of renal failure. 2019 Jul 8;3(7):e017. 2010 Aug;39(2):e93-9. J Trauma. Registered users can save articles, searches, and manage email alerts. His management included emergent fluid resuscitation, fasciotomies, debridement of necrotic muscle from his anterior compartment, and delayed primary closure. Some error has occurred while processing your request. Excruciating low back pain after strenuous exertion: beware of lumbar paraspinal compartment syndrome. CONCLUSIONS We describe the details of this patient's case and review the literature related to acute exertional compartment syndrome. Clipboard, Search History, and several other advanced features are temporarily unavailable. Epub 2008 Jul 2. [email protected]. 2012 Jun;12(3):335-9. For immediate assistance, contact Customer Service:
[ 5] C -. 8600 Rockville Pike Compartment syndrome can develop, with the ischaemic and oedematous muscle raising the intracompartmental pressure potentiating a vicious cycle of continuing ischaemia. All rights reserved. This site needs JavaScript to work properly. Since no electromyography/nerve conduction studies were done, it would be difficult to attribute the cause to a focal rhabdomyolysis and compartment syndrome. It is imperative for orthopedic surgeons to be aware of this potential complication. to maintaining your privacy and will not share your personal information without
Rhabdomyolysis describes the breakdown of striated muscles with the release of intracellular contents and represents a severe muscle injury. modify the keyword list to augment your search. 2016;36(7):685–90. You may be trying to access this site from a secured browser on the server. For some authors, rhabdomyolysis, compartment syndrome and crush syndrome represent different forms of the same disease [6]. acute renal failure
, anuria
, compartment syndrome
, myoglobinuria
, rhabdomyolysis. 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. 2004;14(2):98–100. 30 mins. Complications of rhabdomyolysis are high blood potassium (hyperkalemia), low blood calcium (hypocalcaemia), compartment syndrome, and disseminated intravascular coagulation. 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. 2013 Aug;14(8):1187-91. doi: 10.1111/pme.12135. Compartment syndrome is most commonly due to trauma such as crush injuries or bone fractures. Background: Acute exertional rhabdomyolysis has been infrequently reported among adolescents. 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. J Pediatr Orthop. There have also been reports of rhabdomyolysis and compartment syndrome secondary to viral and statin induced myositis. Accessibility King TW, Lerman OZ, Carter JJ, Warren SM. Orthop Trauma. The authors' aggressive management does have some merit - the MRI findings of muscle edema and clinical findings of supraclavicular fossae being full and tense. Rhabdomyolysis is a syndrome characterized by muscle necrosis and the release of intracellular muscle constituents into the circulation. For information on cookies and how you can disable them visit our Privacy and Cookie Policy. 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. Characterization of the Development of Acute-on-Chronic Exertional Compartment Syndrome A Case Report of Symmetric Compartment Syndromes and Review of the Literature. Diagnosis of atraumatic cases can be difficult, which is why awareness is equally as important as history and physical examination. Rhabdomyolysis is a serious syndrome due to a direct or indirect muscle injury. Rhabdomyolysis is a riddle wrapped in a mystery inside an enigma. Your message has been successfully sent to your colleague. your express consent. His management included emergent fluid resuscitation, fasciotomies, debridement of necrotic muscle from his anterior compartment, and delayed primary closure. The patient Chronic compartment syndrome (CCS) is a recurrent syndrome during exercise or work. J Orthop Trauma. 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.
There may be tea-colored urine or an irregular heartbeat. A classical triad of symptoms includes muscle pain, prostration and dark pigmented urine. Compartments of the leg or arm are most commonly involved. Unable to load your collection due to an error, Unable to load your delegates due to an error. He was diagnosed with compartment syndrome and rhabdomyolysis. Surgery is required to release the compartment to avoid permanent nerve or muscle damage. PMC3387368. 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. -, Matava M, Whitesides T, Seiler J, et al. Lippincott Journals Subscribers, use your username or email along with your password to log in. 2009;23(6):433–40. You may search for similar articles that contain these same keywords or you may
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. All registration fields are required. Compartment syndrome may be either a complication of or the inciting cause of rhabdomyolysis. 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 … Please enable scripts and reload this page. The occurrence of acute compartment syndrome in the absence of trauma or fracture, though rare, can have devastating consequences following delays in treatment. may email you for journal alerts and information, but is committed
2019. Symptoms include severe pain, numbness, and decreased range of motion. Exertional rhabdomyolysis is sequela that is occasionally seen after strenuous exercise. Please try again soon. January 2008; DOI: 10.1007/978-1-84628-937-8_7. While not common, if untreated or not treated quickly enough, compartment syndrome can lead to permanent disability as the body cannot replace dead muscle. Field management with intravenous fluids and extrication is crucial in reducing the risk of complications and death. Rhabdomyolysis: a review of the literature. 2018 Feb;34(2):76-80. doi: 10.1097/PEC.0000000000000647. Exertional rhabdomyolysis in an adolescent athlete. 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. 1994;37(1):50–58. Hohenegger M. Drug induced rhabdomyolysis. 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. 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. Compartment syndrome and/or rhabdomyolysis can occur in Crush syndrome. access full text with Ovid®. He was found to have rhabdomyolysis with evidence of renal insufficiency. Keywords
This is called compartment syndrome. 2017 Apr;75(2):148-152. There are precisely zero RCTs showing benefit of any treatment for rhabdomyolysis. It is most commonly due to physical trauma such as a bone fractur Exertional compartment syndrome of the thigh: a rare diagnosis and literature review. 2010;29(7):803-805. If you're not a subscriber, you can: You can read the full text of this article if you: Institutional members
His con… Pediatr Emerg Care. Rhabdomyolysis is potentially life-threatening although recovery is excellent with early treatment. Rhabdomyolysis resulting from prolonged statin use may be precipitated by strenuous physical exertion and result in compartment syndrome requiring a fasciotomy. 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. 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.