What are the possible causes of this young man’s raised creatine kinase level, and how relevant is this finding?
A 28-year-old Australian (Caucasian) engineer who had been living and working in China for the past three years returned for a holiday and requested a full physical check up. For the two months before his return he had been very busy and had not been exercising much, but prior to that he had been going to the gym regularly and playing rugby. A history revealed no obvious past health problems, safe (heterosexual) sex practices, erratic nutrition (eating take away meals regularly) and regular heavy alcohol intake (at least six standard drinks daily). He was not taking any medications and had a very occasional cigarette (tobacco). His only health complaint was that he often had pains in his knees and ankles and frequently suffered from ‘shin splints’.