1/7. Effort-related chronic compartment syndrome of the lower extremity.Effort-related chronic compartment syndrome (ERCCS) of the lower extremity is often misdiagnosed, requiring repeated visits to the physician and subsequent delay in definitive treatment. The most significant causes of chronic leg pain in physically active individuals are stress fractures, shin splints, and "exercise-induced" or effort-related chronic compartment syndrome. In patients susceptible to ERCCS, the fascial compartments are too small to accommodate the associated 20% increase in muscle mass that typically occurs with heavy exercise. The increased pressure within a small unyielding compartment limits circulation and subsequent muscle function. The only appropriate conservative treatment is cessation of the offending activity. Early suspicion of the condition is paramount, because the definitive treatment is fasciotomy. ERCCS has only recently been recognized, and therefore it may be underdiagnosed. family physicians and general medical officers caring for otherwise healthy soldiers and athletes should be aware of ERCCS so that prompt orthopedic referral for evaluation and definitive treatment will not be delayed.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/7. intermittent claudication in athletes.All reported cases have occurred in the anterior tibial or rarely peroneal compartments. Case I and V in this series follow this same pattern. Case II and III are unusual in that they are the first recorded cases of this syndrome occuring in the calf of a leg. In Case IV the syndrome was present both in the anterior compartment as well as in the calf. Case III in addition, demonstrated arteriographic evidence of impairment of blood flow preoperatively which was relieved by fasciotomy. It is this author's opinion that this syndrome develops due to obstruction of venous drainage by a rise in pressure in the myofascial compartment with exercise. Perhaps it occurs in athletes because the muscle hypertrophy in these patients in greater than that in the general public and the margin of safety is reduced. It is not necessary to perform complicated or painful investigative studies to make the diagnosis. Kennelly and Blumberg state that "a convincing history is all that is necessary," and the author is in complete agreement with this statement. Fasciotomy gives complete relief and is earnestly recommended both to relieve symptoms and to prevent the catastrophic consequences of muscle necrosis. In fact, in severe cases it is best to advise cessation of physical exercise until the operation can be done in order that this severe complication does not develop.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/7. Exertional compartment syndrome and the role of magnetic resonance imaging.A 47-yr-old woman presented with a 1-yr history of progressive bilateral anterior lower leg pain and swelling with walking, which resolved 10 min after activity. Postexercise (forced dorsiflexion) magnetic resonance imaging revealed increased T2 signal intensity in the entire anterior muscle compartment, and anterior compartment pressures were elevated at rest and postexercise. Chronic exertional compartment syndrome can occur in some patients after even minimal physical activities, and magnetic resonance imaging without the use of radioisotopes was a useful adjunct for diagnosis.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/7. Anterior tibial compartment syndrome due to the pyomyositis in a patient with rheumatoid arthritis. A case report.Anterior tibial compartment syndrome was developed due to pyomyositis in a 33-year-old male patient with rheumatoid arthritis while receiving steroid therapy during the follow-up period. The preoperative physical examination, laboratory findings, MRI images, intraoperative observation and postoperative histopathological examinations confirmed the association with pyomyositis. The surgical drainage and antibiotic treatment were effective, and in the follow-up period, neuromuscular dysfunctions disappeared completely within 6 months. The patient has been asymptomatic for 4 years of follow-up. To date, anterior tibial compartment syndrome due to pyomyositis in a case with rheumatoid arthritis has not been reported.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/7. Acute anterior compartment syndrome in the thigh: a case report and review of the literature.An unusual case of acute anterior thigh compartment syndrome promptly recognized and successfully treated in a young athletic patient is presented and the literature reviewed. With the increased interest in physical fitness in today's society, this condition may occur more frequently than it is recognized. Prompt diagnosis and treatment can reduce morbidity.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
6/7. Acute compartment syndrome (anterior, lateral, and superficial posterior) following tear of the medial head of the gastrocnemius muscle. A case report.This case report documents an acute tear of the gastrocnemius muscle which resulted in an acute compartment syndrome of the anterior, lateral, and superficial posterior compartments of the leg. Prompt diagnosis by physical examination and Wick catheter, followed by surgical compartment release, resulted in a well-functioning extremity. Followup at 18 months revealed a normally functioning extremity, and Cybex evaluation revealed increased muscle strength in the involved extremity.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
7/7. Acute exertional anterior compartment syndrome in an adolescent female.Acute compartment syndromes usually occur as a complication of major trauma. While the chronic exertional anterior tibial compartment syndrome is well described in the sports medicine literature, reports of acute tibial compartment syndromes due to physical exertion, or repetitive microtrauma, are rare. The case of an adolescent female who developed an acute anterior compartment syndrome from running in a soccer game is described in this report. Failure to recognize the onset of an acute exertional compartment syndrome may lead to treatment delay and serious complications. Whereas the chronic exertional anterior compartment syndrome is characterized by pain that diminishes with the cessation of exercise, the onset of the acute exertional anterior compartment syndrome is heralded by pain that continues, or increases, after exercise has stopped. Compartment pressure measurement confirms the clinical diagnosis and helps guide treatment. True compartment syndromes require urgent fasciotomy.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |