A Case of Misdiagnosis of Rhabdomyolysis

Rhabdomyolysis is a very common clinical syndrome, and misdiagnosing it is a common occurrence in the emergency department. The presentation of rhabdomyolysis can be confusing due to the overlap of its symptoms with other very common diseases. The main presenting symptoms of rhabdomyolysis are predominantly characterized by generalized myalgias and weakness. Acute renal failure due to acute tubular necrosis caused by myoglobin is a classic feature. Although decisive criteria for diagnosing rhabdomyolysis remain lacking, an elevated creatinine kinase level of more than at least ten times its normal value is used as the gold-standard diagnostic test. Therefore, a well-devised approach should be taken into consideration when assessing patients with certain alarming symptoms in the emergency department. Symptoms such as fever, nausea, and vomiting are nonspecific; however other alarming symptoms such as kidney injury, compartment syndrome, darkening of the urine, and arrhythmias are signs of complications that may arise from rhabdomyolysis. Here we discuss a case of rhabdomyolysis that was misdiagnosed and present the necessary evidence-based material to avoid a potential misdiagnosis and further complications.