History

The modern history of rhabdomyolysis begins with Bywaters and Beal’s classic description of the entrapped bombing victims in the London blitz in the 1940s. Indeed, clusters of rhabdomyolysis cases are seen still around the world during wartime, terrorism and when buildings collapse.

Rhabdomyolysis may follow entrapment in road and rail accidents.

The main clinical manifestations of rhabdomyolysis are:

• Weakness
• Myalgia
• Brownish (tea coloured) urine

The management of patients with rhabdomyolysis includes resuscitation followed by measures to preserve renal function. The use of osmotic diuretics and alkalinising agents remains unproven.

The condition is so rare in children that, depending on age and history, the emergency physician should first consider inherited metabolic disorders.