Exertional Rhabdomyolysis: What you don’t diagnose may kill a patient. Prof Francis O’Connor

What is rhabdomyolysis? Can it sneak under a clincian’s radar? What the key clinical features? When to be alert for rhabdomyolysis Problems when coaches are too aggressive with a new load Two cases – clinical scenarios When sickle cell trait complicates matters Which athlete with sickle cell trait is at increased risk? Can clinicians identify the athlete with sickle cell trait who is at risk of death? To screen or not to screen. Ethics and science. Who is ready to return to play? Who is at risk of recurrence? It applies to athletes and war fighters. Role of genetics – the genetic markers that clinicians can test for in a tertiary care centre Links to a previous podcast by Fran O’Connor – Exertional leg pain http://ow.ly/j9IU30bs1oe Links to papers: Sickle Cell paper in Medicine and Science in Sports and Exercise: https://www.ncbi.nlm.nih.gov/pubmed/?term=harmon+and+Med+Sci+Sports+Exerc Pathophysiology of exertional death associated with sickle cell trait: can we make a parallel with vaso-occlusion mechanisms in sickle cell disease? Connes P, Harmon KG, Bergeron MF. http://bjsm.bmj.com/content/47/4/190.long Sickle cell trait associated with a RR of death of 37 times in National Collegiate Athletic Association football athletes: a database with 2 million athlete-years as the denominator. Harmon KG, Drezner JA, Klossner D, Asif IM. http://bjsm.bmj.com/content/46/5/325.long To screen or not to screen for sickle cell trait in American football? Harmon KG, Drezner JA, Casa DJ. http://bjsm.bmj.com/content/46/3/158.long Return to Physical Activity After Exertional Rhabdomyolysis O'Connor FG; Brennan FH, et al. http://journals.lww.com/acsm-csmr/Fulltext/2008/11000/Return_to_Physical_Activity_After_Exertional.8.aspx