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Non\u2010specific exercise\u2010induced myalgia in the presence of muscle hypertrophy and a high creatine kinase will point towards a muscular dystrophy. Symptoms occurring within minutes of exercise and with isometric contraction, especially with a history of a \u2018second wind\u2019 phenomenon, suggest a disorder of glycogen metabolism. In those patients in whom symptoms occur after prolonged exercise, infections, fasting, stress, and cold, a disorder of fatty acid oxidation should be considered. Heat\u2010induced rhabdomyolysis caused by exercising in hot and humid climates should lead the clinician to suspect a mutation in <jats:italic>RYR1<\/jats:italic>. Serum creatine kinase level should be a checked in all children presenting with leg pains. A careful history and examination and laboratory confirmation of myoglobinuria will target investigations leading to a correct molecular diagnosis.<\/jats:p>","DOI":"10.1111\/j.1469-8749.2012.04320.x","type":"journal-article","created":{"date-parts":[[2012,5,23]],"date-time":"2012-05-23T07:27:08Z","timestamp":1337758028000},"page":"886-891","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":54,"title":["Myopathic causes of exercise intolerance with 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