Rhabdomyolysis is the breakdown of muscle tissue with release of intracellular contents such as myoglobin into the bloodstream. The condition usually follows major muscle trauma, especially a crush injury. It can also be caused by long-distance running, hyperthermia, infection, drugs, toxins, and electrolyte disturbances, among others.
Rhabdomyolysis is characterized by myalgias, weakness, and dark urine due to myoglobinuria. Muscle trauma may lead to compartment syndrome involving tissue hypoxia, muscle infarction, and neural damage. Creatine kinase (CK) levels are usually markedly elevated. Myoglobin may occlude the structures of the kidney and break down into toxic compounds leading to acute tubular necrosis or acute renal failure.
Management of rhabdomyolysis involves treating the underlying disorder, preventing renal failure by providing early and aggressive IV hydration, correcting electrolyte abnormalities, and recognizing and treating compartment syndrome if present.