“…[ 1 ] If not treated promptly, it can progress to a series of sequelae including: weakness, contracture, deformity, motor paralysis, and sensory neuropathy. [ 2 ] Therefore, timely diagnosis and surgical decompression are the most effective methods to prevent the morbid consequences. [ 3 ]…”
Rationale:Acute compartment syndrome is a highly aggressive condition, which needs rapid diagnosis and surgical emergency. Most cases are caused by trauma, fractures, surgeries, or vascular injury, while other causes are easily misdiagnosed.Patients concerns:A 29-year-old female, with a medical history of an insect bite on the left calf but not recent trauma, was admitted to the hospital due to the swelling and pain around the bite area.Diagnoses:Acute compartment syndrome of the lower leg.Interventions:After admission, she developed septic shock symptoms, given intravenous antibiotics treatments. However, the condition worsened with increasing pain, loss of sensation, tense swelling, and severe pain to any stretch of the tissues. Thus the patient received fasciotomy followed by repeat and thorough debridement. After the wounds healed completely, systematic rehabilitation was performed for three weeks.Outcomes:After three months of follow-up, the patient is able to walk, and moves up and down the stairs, independently.Lessons:Our case highlights the possibility of acute compartment syndrome caused by insect bites when the patient presents with the signs of the condition, and the importance of earlier rehabilitation interventions to improve the functional outcome post operation.
“…[ 1 ] If not treated promptly, it can progress to a series of sequelae including: weakness, contracture, deformity, motor paralysis, and sensory neuropathy. [ 2 ] Therefore, timely diagnosis and surgical decompression are the most effective methods to prevent the morbid consequences. [ 3 ]…”
Rationale:Acute compartment syndrome is a highly aggressive condition, which needs rapid diagnosis and surgical emergency. Most cases are caused by trauma, fractures, surgeries, or vascular injury, while other causes are easily misdiagnosed.Patients concerns:A 29-year-old female, with a medical history of an insect bite on the left calf but not recent trauma, was admitted to the hospital due to the swelling and pain around the bite area.Diagnoses:Acute compartment syndrome of the lower leg.Interventions:After admission, she developed septic shock symptoms, given intravenous antibiotics treatments. However, the condition worsened with increasing pain, loss of sensation, tense swelling, and severe pain to any stretch of the tissues. Thus the patient received fasciotomy followed by repeat and thorough debridement. After the wounds healed completely, systematic rehabilitation was performed for three weeks.Outcomes:After three months of follow-up, the patient is able to walk, and moves up and down the stairs, independently.Lessons:Our case highlights the possibility of acute compartment syndrome caused by insect bites when the patient presents with the signs of the condition, and the importance of earlier rehabilitation interventions to improve the functional outcome post operation.
In modern practice, imaging plays an integral role in the diagnosis, evaluation of extent, and treatment planning for lower extremity infections. This review will illustrate the relevant compartment anatomy of the lower extremities and highlight the role of plain radiographs, CT, US, MRI, and nuclear medicine in the diagnostic workup. The imaging features of cellulitis, abscess and phlegmon, necrotizing soft tissue infection, pyomyositis, infectious tenosynovitis, septic arthritis, and osteomyelitis are reviewed. Differentiating features from noninfectious causes of swelling and edema are discussed.
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