Exertional rhabdomyolysis has been previously reported in adult patien
ts following such strenuous activities as military basic training, wei
ght lifting, and marathon running. Exertional rhabdomolysis in previou
sly healthy-pediatric athletes, however, is rarely encountered, The pr
esentation of rhabdomyolysis is characterized by the classical triad o
f myalgias, muscle weakness, and darkened urine, This classic presenta
tion, however, is not noted in the majority of patients, especially ea
rly in the disease course when the patient may complain only of myalgi
as or weakness. Thus, the emergency physician most have a high index o
f suspicion for this entity based on the appropriate clinical setting,
We report a classic case of exercise-induced rhabdomyolysis complicat
ed by acute renal failure in a previously healthy adolescent athlete,
whose initial presentation was nonspecific, prompting the diagnosis of
overexertion.