This case demonstrates the breadth of anatomic and physiologic understanding a clinician must draw on when approaching patients with nerve root compression symptoms. It is also pertinent to consider performing a hypercoagulable work-up in patients with vascular deformations, as this may prevent future thrombosis.
We report a case of an 86-year-old male with a history of dyslipidemia, which had been treated with a medication regimen that included niacin. Upon discontinuation of niacin by his physician, he noticed recurrence of aching pain on the dorsal surface of the foot where he had a scar from a World War II shrapnel injury. With reinitation of niacin, his pain again abated.
A 28-year-old soldier presented with chronic right-lower-leg pain that had persisted for the past 18 months. Following previous primary care and specialty referrals, he had been diagnosed with atraumatic compartment syndrome. Prior lower-extremity magnetic resonance imaging (MRI) had been evaluated as normal. Subsequent physical examination revealed an appreciable soft-tissue depression, which became elevated after brief exercise. Ultrasonography confirmed this to be a previously undiagnosed fascial defect of the anterolateral compartment with tibialis anterior muscle herniation.
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