Unusual Presentation of Compartment Syndrome

Papachristos, Ioannis V.; Giannoudis, Peter V.

doi:10.1007/978-3-030-22331-1_15

Cited by 4 publications

(8 citation statements)

References 79 publications

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“…Chronic exertional compartment syndrome (CECS) is classically seen in young athletic people. The etiology is not fully understood with several proposals suggesting repetitive microtrauma, infection, decreased compartmental elasticity or eosinophilic fasciitis as causes [2] , [3] , [4] . Proposed pathophysiology involves increased intramuscular pressures leading to reduced perfusion and subsequent ischemic pain.…”

Section: Discussionmentioning

confidence: 99%

Chronic exertional compartment syndrome of the quadriceps femoris

Ryan,

Hanley,

Eustace

et al. 2024

Radiology Case Reports

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Section: Discussionmentioning

confidence: 99%

Chronic exertional compartment syndrome of the quadriceps femoris

Ryan,

Hanley,

Eustace

et al. 2024

Radiology Case Reports

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“…Compartment syndrome is described as increased pressure in a contained fibro-osseous compartment, leading to impaired perfusion pressure and subsequent neuromuscular hypoxia or ischemia. [ 13 ] The typical scenario for acute compartment syndrome involves lower limb fractures or crush injuries. However, physicians may occasionally encounter insidious and atypical presentations, defined as ACS.…”

Section: Discussionmentioning

confidence: 99%

Atypical compartment syndrome of the forearm due to mixed infection with Proteus mirabilis and Morganella morganii after a penetrating injury: A limb-saving approach

Yeşil,

Özcan,

Karasu

et al. 2023

Jt Dis Relat Surg

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Compartment syndrome requires early surgical intervention and close follow-up with proper medical treatment, as it has a progressive course over time, and irreversible tissue necrosis may occur if ischemia is not treated for >8 h. [1,2] The gold-standard approach in the diagnosis of compartment syndrome is to measure the difference between the diastolic blood pressure and compartment pressure. [3,4] However, this method is not preferred in routine practice, and appropriate equipment is not available in most centers. Therefore, the diagnosis of compartment syndrome relies heavily on clinical suspicion. [5] Compartment syndrome can sometimes have an atypical presentation with an insidious onset, Compartment syndrome is a well-described clinical condition and is considered an orthopedic emergency affecting individuals of all ages. A typical scenario for acute compartment syndrome involves lower limb fractures or crush injuries. However, physicians may occasionally encounter atypical presentations, defined as atypical compartment syndrome (ACS). A 38-year-old, left-handed male patient without any comorbidities developed ACS of the forearm and clinical presentation of sepsis after a small penetrating injury to his right forearm. He developed ACS secondary to infected hematoma and subsequent soft tissue infection caused by Proteus mirabilis and Morganella morganii. Both bacteria infected the patient by direct contamination after injury with a knife, resulting in multifloral contamination. The patient was successfully treated with reconstructive surgery. In conclusion, ACS secondary to this type of penetrating injury shows a subtle clinical course at the time of hospital admission and can insidiously progress from an infected hematoma, posing a serious threat to the limb or even cause mortality. Good extremity function without any disability can be achieved with an accurate diagnosis during the initial evaluation of the patient in the emergency department and prompt surgical intervention followed by appropriate reconstructive methods.

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“…An uncommon cause for the development of acute compartment syndrome has been attributed to creatinine supplementation taken by athletes and individuals when engaging in intensive physical exercise [ 11 ]. Alternatively, acute exertional compartment syndrome has been observed in sedentary individuals who suddenly over-enthusiastically engage in exercise [ 4 ]. Our patient had no obvious risk factors, intrinsic or acquired, that predisposed him to developing acute compartment syndrome, making his situation an idiopathic spontaneous compartment syndrome.…”

Section: Discussionmentioning

confidence: 99%

“…Our patient had no obvious risk factors, intrinsic or acquired, that predisposed him to developing acute compartment syndrome, making his situation an idiopathic spontaneous compartment syndrome. This is a very uncommon phenomenon, rarely reported in the medical literature, with only a few case reports to date [ 4 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…In the presence of a known predisposing risk factor and a clear history, acute compartment syndrome can be suspected based on its classical clinical presentation of pain, pallor, paresthesia, poikilothermia and paralysis [ 1 ]. However, in the absence of any obvious risk factors, idiopathic spontaneous acute compartment syndrome is a rarely reported phenomenon and may pose a diagnostic challenge [ 4 ]. Delay in triage and diagnosis can have a lasting impact on patient morbidity and mortality, with medicolegal implications [ 5 ], highlighting the need for a low threshold of clinical suspicion and greater awareness of its presentation even in the absence of obvious etiology.…”

Section: Introductionmentioning

confidence: 99%

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Idiopathic spontaneous compartment syndrome of the right lower limb: a case report

Bandapaati

Mitrakrishnan

2021

J Med Case Reports

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Background Acutely painful lower limb is a common presentation to the emergency department, and acute compartment syndrome is an important differential diagnosis to consider given the correct predisposing history and clinical presentation. However, idiopathic spontaneous compartment syndrome is an uncommon occurrence. Case presentation A 54-year-old Caucasian man with no previous comorbidities presented with acute right-sided lower limb pain with classical symptoms showing gradual evolution. He had no other history of medical relevance and no preceding injury. Examination showed a marginally enlarged right lower limb with stretched skin and tenderness. Routine blood tests were normal including D-dimer levels. However, in the absence of any underlying risk factors, acute compartment syndrome was suspected on clinical merit and confirmed with magnetic resonance imaging. He underwent successful surgical intervention with fasciotomy and achieved good recovery. Discussion Acute compartment syndrome, though commonly attributed to trauma, can occur due to varied causes. Spontaneous acute compartment syndrome is attributed to diabetes mellitus. Idiopathic acute spontaneous compartment syndrome occurs in the absence of either intrinsic or extrinsic risk factors and is rarely documented in the literature. This case highlights the importance of appreciating classical clinical signs and having the clinical acumen to consider an obvious diagnosis even in its rarer form of presentation.

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Unusual Presentation of Compartment Syndrome

Cited by 4 publications

References 79 publications

Chronic exertional compartment syndrome of the quadriceps femoris

Chronic exertional compartment syndrome of the quadriceps femoris

Atypical compartment syndrome of the forearm due to mixed infection with Proteus mirabilis and Morganella morganii after a penetrating injury: A limb-saving approach

Idiopathic spontaneous compartment syndrome of the right lower limb: a case report

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