Pearls
- Historical and clinical findings are important- is there evidence of muscle disease or injury?
- On the biochemical panel, look for increased CK activity. AST and ALT activity may also be increased due to muscle injury, but liver disease must be ruled out as the source of these findings.
- Remember that many muscle diseases do not result in increases in CK activity. Diseases with inflammation and necrosis are most likely to result in increases in CK activity.
- Myoglobinuria and red-brown urine may be seen with muscle injury, and must be differentiated from hematuria and hemoglobinuria.
- Specialized testing is needed to confirm many muscle disorders.
