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Extremity Swelling 

Extremity Swelling
Extremity Swelling
Acute Care Casebook

Jennifer Repanshek


The case illustrates the classic clinical features and emergent management of rhabdomyolysis. The pathophysiology results from the breakdown of muscle from intense exercise, drug or alcohol use, seizure activity, trauma, heat illness, or muscle disorders. The clinical history is of a severe muscle pain, sometimes focused on a single muscle group or extremity but often diffuse. Rhabdomyolysis should be suspected in a patient with vague complaints of muscle pain, and an elevation in creatine kinase is diagnostic in this clinical picture. Patients who have been diagnosed with rhabdomyolysis must also be carefully evaluated for compartment syndrome. The mainstay of treatment is aggressive intravenous fluid administration. Serial creatine kinase values as well as the patient’s evolving clinical status should guide further management.

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