An Unusual Presentation of Rhabdomyolysis

​BY DAVID DIAZ; JONATHAN HAVERTY, DO; & JORGE DIAZ, DOA previously healthy 20-year-old woman presented to the emergency department with three days of bilateral thigh pain. The pain had initially started in a focal area of the anterior aspect of the lower thighs bilaterally. The next day, her pain had progressed to involve a larger area of her thighs, and she noticed redness and swelling in the same area.She had difficulty walking and bending her legs due to the pain. She said no other muscle groups were involved and she had never experienced this before. The patient had no history of vigorous physical activity or trauma, illicit drug use, recent travel, and insect bites. She had no other symptoms or history other than a recent URI, which had resolved a week earlier.Her vital signs were unremarkable, and she was well-appearing and in no distress. The anterior aspect of the thighs bilaterally was tender with mild swelling and erythema. Her legs were symmetric, and no joint involvement was apparent. She had intact sensation and pulses distally and only mildly diminished quad strength bilaterally, but the exam was limited due to pain.On a hunch, a creatine kinase level was ordered and came back with a surprising result of 33,000 U/L. We then ordered a urinalysis, liver panel, CBC, basic metabolic panel, pregnancy test, and urine toxicology screen for drugs of abuse. The urine was described by the lab as clear, yellow, and dipstick positive for moderate heme with only one RB...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research