Physiological ERM | Clinically significant ERM | |
---|---|---|
Clinical features | Only myalgia | Also muscle weakness and/or swelling and/or altered consciousness |
Vital signs | Normal | Abnormal and/or body temperature >40°C (heat stroke) |
Exercise | Clearly unaccustomed | Accustomed/unaccustomed |
CK (U/L) | <10 000 | ≥10 000 |
Myoglobinuria/myoglobinaemia | Absent | Present |
Acute renal failure | Absent | Absent or present |
Electrolyte abnormalities | Absent | Absent or present |
Acid base status | Normal | Abnormal |
Other factors possibly provoking rhabdomyolysis | Absent | Absent or present |
History |
|
|
Outpatient follow-up if all normal | Referral to the ER in case of any of these factors |
CK, creatine kinase; ERM, exertional rhabdomyolysis.