Muscle Trauma

MU. Meltzer, H., Intramuscular chlorpromazine and creatine kinase Acute psychosis or local muscle trauma. Science 164, 726-727 (1969). 

A 50-year-old man who was treated with ziprasidone 40 mg bd for 3 weeks had a substantial rise in creatine kinase activity without any evidence of muscle trauma, stiffness, or swelling or any signs of neuroleptic malignant syndrome (29). There was no renal insufficiency or compartment syndrome. 

Creatine is a nitrogenous organic acid normally present in muscle and other tissues. When muscle is injured, creatine leaks out and can be measured in the blood as creatine kinase (CK). Blood levels of CK are increased when heart muscle is damaged, but also in muscle trauma, polymyositis, rapidly worsening cases of muscular dystrophy, vigorous exercise, or for no apparent reason. 

Centrally acting muscle relaxants depress neuron activity in the spinal cord or in the brain and are used to treat acute spasms from muscle trauma. Centrally acting muscle relaxants decrease pain, increase range of motion,... 

Diazepam (Valium) (for chronic neurologic disorders and muscle trauma)... 

Rhabdomyolysis is the breakdown of muscle fibers, the result of skeletal muscle injury, which leads to the release of potentially toxic intracellular contents into the plasma. The causes are diverse muscle trauma from vigorous exercise, electrolyte imbalance, extensive thermal burns, crush injuries, infections, various toxins and drugs, and a host of other factors. 

Exercise and muscle trauma can increase serum CK. Sustained exercise, such as in weU-trained long-distance runners, increases the CK-MB content of skeletal muscle, which may produce abnormal serum CK-MB concentrations. 

These are used to treat acute spasms from muscle trauma and for treating spasms caused by chronic neurologic disorders. 

Matziolis, D., G. WassUew, P. Strube, G. MatzioUs, and C. Perka (2011). Differences in muscle trauma quantifiable in the laboratory between the minimally invasive anterolateral and trans-gluteal approach. Anc/i Orthop Trauma Surg 131(5) 651-655. Maughan, D. W., J. A. Henkin, and J. O. Vigoreaux (2005). Concentrations of glycolytic enzymes and other cytosolic proteins in the diffusible fraction of a vertebrate muscle proteome. Mol Cell Proteomics 4(10) 1541-1549. 

There are three main complications of muscle tear cysts and myositis ossificans and, more rarely, calcific myonecrosis (Peetrons 2002). Intermuscular and intramuscular cysts may be encountered after muscle trauma as well-defined echo-free masses with posterior acoustic enhancement. These cysts have an elongated shape and represent the residue of a local hematoma. Their most common location is the calf (see Chapter 15). In selected cases, they may require percutaneous needle evacuation. Calcific myonecrosis is a space-occupying calcified mass that typically develops in the anterior compartment of the leg late after a closed lower extremity... 

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