Rhabdomyolysis

00:00 Next, let's move to rhabdomyolysis. This is a critical pathology to understand. It must be recognized quickly and intervene the pun. What is rhabdo? Well, this is extensive myonecrosis on a massive and generalized scale. This is every muscle in the body or many of them degenerating and dying. There are several etiologies or causes of rhabdomyolysis and we see, one, mechanical injury. Physical injury of the muscle results in disruption of the cellular membrane, release of CK, and muscle damage on a widespread scale. The second is energy depletion. In conditions where there is massive reduction in the amount of circulating energy within the body we see subsequent cellular breakdown, muscle enzyme release, and myonecrosis again on this massive scale. And you can see here on the picture necrosis of muscle fibers. This can be seen in a number of conditions. And when evaluating patients, you're going to be thinking about these conditions and in a patient who has myalgias, or increased CK, or renal dysfunction, you are going to think "Hmmm, could they have rhabomyolysis?" Trauma. Trauma can cause widespread muscle damage and injury and contribute to the development of rhabdo. Excessive exertion. Not like going out and running a mile, but certain patients who run a marathon or status epilepticus where there is widespread muscle contraction for a prolonged and persisting period of time can result in the development of rhabdo. Metabolic disorders, mitochondrial myopathies, glycogen storage disorders, severe hyperthermia can cause widespread muscle damage, electrolyte imbalances, in certain toxins or drugs.