Because of the patient's severe pain and limited history, a full workup was performed. CT pan-scan was notable for asymmetric enlargement of the left posterior paraspinal musculature with diminished attenuation. The remainder of the CT was unremarkable. Pertinent diagnostics included a creatinine phosphokinase (CPK) of 28,040 U/L (normal range, 30 to 170 U/L), creatinine of 2.22 mg/dL (normal range, 0.7 to 1.3 mg/dL), alanine transaminase (ALT) of 521 U/L (normal range, 0 to 35 U/L), aspartate transaminase (AST) of 982 U/L (normal range, 0 to 35 U/L), and urinalysis with amber urine and microscopic hematuria.Epidural abscess was unlikely because the patient's white blood cell count and erythrocyte sedimentation rate were within normal limits, and he had no evidence of abscess on imaging. CT also showed no evidence of mass, lytic lesions, or disk herniation, ruling out spinal cord compression and herniated nucleus pulposus. The patient was diagnosed with rhabdomyolysis due to a signifi cantly elevated CPK and elevated creatinine and was treated with aggressive IV fl uids and opioids. After 8 hours of therapy, his CPK had increased to 36,560 U/L, despite an improved