A
Yes, retching and forceful vomiting can raise CK levels, but usually only mildly and transiently.
Mechanism:
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Violent retching and vomiting involve forceful contraction of abdominal, intercostal, and diaphragmatic muscles.
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This muscle exertion or microtrauma can lead to mild elevations in creatine kinase (CK), particularly CK-MM, the skeletal muscle isoenzyme.
Clinical Significance:
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The elevation is usually not dramatic—typically less than 1,000 U/L, unless:
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The vomiting is prolonged or extreme.
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There is underlying muscle vulnerability (e.g., metabolic myopathy, dehydration, or concurrent rhabdomyolysis).
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If CK is markedly elevated, consider other causes (e.g., seizures, ischemia, rhabdomyolysis, or myocardial injury).
Would you like a quick reference chart summarizing CK sources and patterns?
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Glass is usually radiopaque, but not all types of glass are equally visible on X-ray. Here's a quick breakdown:
✅ Radiopaque (visible on X-ray)
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Silica-based glass (e.g., most bottle glass, window glass)
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Lead glass/crystal
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Automobile safety glass
⚠️ Potentially Radiolucent (not always visible)
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Tempered glass
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Thin cosmetic or optical glass
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Some plastic-glass composites
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Very small or thin fragments may also be missed.
🩻 Best Imaging Practices
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Soft tissue X-ray (neck, chest, abdomen) in two views (AP & lateral)
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If high suspicion and normal X-ray → consider CT scan, which is more sensitive.
🧠 Clinical Pearl:
Even if X-ray is normal, do not rule out glass presence if history and symptoms suggest ingestion or injury. Always base decisions on both clinical findings and imaging.
Would you like a visual comparing radiopacity of common foreign bodies in children (e.g., glass, plastic, metal, bone)?
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