The history of a preceding influenza-like infection followed by the typical symptoms of acute onset of symmetrical calf pain and gait problems together with an isolated finding of a high level of
creatine kinase suggests the diagnosis of BACM.
Myoglobinuria is rare and points to the possibility of the development of rhabdomyolysis and kidney failure.
Guillain-Barré syndrome (GBS) is the main consideration in the differential diagnosis. It needs to be quickly excluded as early intervention in GBS is indicated. Other conditions under possible consideration are
dermatomyositis,
muscular dystrophy,
juvenile idiopathic arthritis,
transient synovitis of the hip,
osteomyelitis, and
myalgia. Few muscle biopsies have been conducted. Results may show normal findings or features of inflammation and necrosis. ==Preceding viral infections==