Differential Diagnosis for Bilateral Arm Swelling after Strenuous Exercise
- Single most likely diagnosis
- Rhabdomyolysis: This condition is characterized by the breakdown of muscle tissue, leading to the release of muscle fiber contents into the blood. The high CK level (7000) strongly supports this diagnosis, and the recent history of strenuous exercise is a common precipitating factor. The swelling in the arms could be due to the localized muscle damage from the exercise.
- Other Likely diagnoses
- Exertional Rhabdomyolysis with Compartment Syndrome: Although the patient does not have muscle tenderness, compartment syndrome is a possible complication of rhabdomyolysis, especially after strenuous exercise. The swelling could be indicative of increased pressure within the muscle compartments.
- Protein Shake-induced Allergic Reaction or Intolerance: The introduction of new protein shakes 2 days before the onset of swelling could potentially be related to an allergic reaction or intolerance, although this would be less likely given the high CK level.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Deep Vein Thrombosis (DVT): Although less likely given the bilateral nature and the context of recent exercise, DVT should always be considered in cases of limb swelling. It's crucial to rule out DVT due to its potential for severe complications, such as pulmonary embolism.
- Nephrotic Syndrome: This condition involves significant protein loss in the urine, leading to hypoalbuminemia, which can cause edema. However, the acute onset and the specific context provided make this less likely, but it's a condition that could have severe implications if missed.
- Rare diagnoses
- Dermatomyositis: An inflammatory disease characterized by muscle weakness and skin rash. While it could explain the elevated CK and swelling, the absence of other typical symptoms like skin rash and muscle weakness makes it less likely.
- Amyloidosis: A condition characterized by the deposition of amyloid proteins in various tissues, which can lead to swelling among other symptoms. It's a rare condition and would be an unlikely cause of acute bilateral arm swelling following exercise.