Rhabdomyolysis results from the death of muscle fibers from injury, and the release of their contents into the blood stream. It has many causes ranging from injury to medications and can result in acute kidney injury.  Classic symptoms include pain, weakness, and dark red or brown urine. Creatine kinase, a product of muscle breakdown, can be measured in blood to monitor treatment.  Most cases are reversible.  

Rhabdomyolysis may occur when a patient is lying on a hard surface for a prolonged period of time.  Although there are a variety of alternate causes of rhabdomyolysis, such as medications, infections, electrical shocks or metabolic conditions that create heightened muscle tone or low oxygen flow to an area, by far the most common cause is trauma and muscle compression.  In the practice of forensic pathology, confinement in a fixed position is the most common cause of rhabdomyolysis that leads to death.  The compression of muscle causes cell death and release of intracellular materials into the blood stream.  One major protein released, myoglobin, is toxic to the kidneys.  The damaged muscle cells also absorb fluids, causing a shift of fluid from the bloodstream into the area causing low blood volume; this then leads to low blood flow to the kidneys.  This further worsens kidney failure.  When rhabdomyolysis is diagnosed, prompt and aggressive fluid hydration is critical to increase blood flow to the kidneys and speed passage of the toxic myoglobin through the kidneys in order to reduce damage.

Rhabdomyolysis medical expert witness specialties include pathology,hematology, rheumatology, nephrology, forensic pathology, critical care medicine, pediatric critical care medicine, and emergency medicine.

IF YOU NEED A Rhabdomyolysis MEDICAL EXPERT, CALL MEDILEX AT (212) 234-1999.