Related Experiment Video
Updated: Jan 28, 2026
09:02
A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
Published on: February 2, 2021
4.9K
Drug-induced paraspinal myositis mimicking acute bilateral sciatica
Richard Pearse1, Ravindran Visagan1, Kiran Reddy2
1Emergency Department, Guy's and Saint Thomas' NHS Foundation Trust, London, UK.
BMJ Case Reports
|February 24, 2019
Summary
Cocaine use can cause rare paraspinal myositis, leading to severe sciatica and acute kidney injury. Prompt diagnosis and steroid treatment resolved symptoms, highlighting the importance of social history in emergency presentations.
Area of Science:
- Toxicology
- Neurology
- Rheumatology
Background:
- Cocaine-induced myopathy and myotoxicity are documented.
- This case presents a rare instance of cocaine-induced paraspinal myositis.
- The condition manifested with acute sciatic symptoms.
Observation:
- A 35-year-old male presented with severe, bilateral sciatica.
- Initial investigations revealed elevated inflammatory markers, creatinine, and creatine kinase (CK).
- Lumbar MRI showed paraspinal inflammation, and muscle biopsy confirmed myositis.
Findings:
- The patient was a cocaine user, linking the myositis to substance misuse.
- Treatment with prednisolone resulted in significant improvement in renal function, CK levels, and C-reactive protein (CRP).
- The patient recovered fully within six weeks.
Implications:
- This case underscores the importance of detailed social history, including substance misuse, in emergency department evaluations for severe musculoskeletal pain.
- Drug-induced myotoxicity, though rare, can present with severe symptoms and renal failure.
- Early recognition and management of cocaine-induced paraspinal myositis are crucial for patient recovery.
Related Concept Videos
01:30Acute Pharyngitis
4.1K
Introduction
Acute pharyngitis is the inflammation of the back of the throat (pharynx), commonly resulting in a sore throat. It is a frequently encountered condition that prompts individuals to seek medical advice.
Classification
Acute pharyngitis can be categorized based on its underlying cause:
Acute pharyngitis is the inflammation of the back of the throat (pharynx), commonly resulting in a sore throat. It is a frequently encountered condition that prompts individuals to seek medical advice.
Classification
Acute pharyngitis can be categorized based on its underlying cause:
4.1K
01:27Acute Pancreatitis I: Introduction
1.2K
Pancreatitis is inflammation of the pancreas, an organ located behind the stomach. It can be either acute or chronic.
Acute pancreatitis is characterized by rapid inflammation of the pancreas, often caused by factors like gallstone blockage or excessive alcohol consumption. Chronic pancreatitis, on the other hand, is a slow, progressive inflammation that may result from long-term alcohol abuse, obstructions in the pancreatic duct, or genetic factors.
The causes of acute pancreatitis include:
Acute pancreatitis is characterized by rapid inflammation of the pancreas, often caused by factors like gallstone blockage or excessive alcohol consumption. Chronic pancreatitis, on the other hand, is a slow, progressive inflammation that may result from long-term alcohol abuse, obstructions in the pancreatic duct, or genetic factors.
The causes of acute pancreatitis include:
1.2K
01:21Acute Respiratory Failure-I
977
Acute respiratory failure is a condition characterized by the inability of the lungs to perform their primary function: gas exchange. This failure leads to insufficient oxygen levels (hypoxemia) in the blood, elevated carbon dioxide levels (hypercapnia), or both, causing critical impairment in organ function.
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...
977
01:21Acute Respiratory Failure-II
1.1K
Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
1.1K
01:29Acute Respiratory Failure-V
493
The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Ensure that patients are monitored continuously for their response to therapy, including changes in...
493
01:27Acute Pyelonephritis I: Introduction
620
Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such...
620