Orthopaedic Sports Medicine
This patients presentation and clinical findings are consistent with acute exertional compartment syndrome (ECS) of the leg. The hallmark presentation for ECS is pain out of proportion to physical examination findings. ECS arises when increased pressure develops within a myofascial compartment, which compromises circulation and function of the enclosed tissues. Although cardiac stress testing, computed tomographic scan of the leg, Doppler sonogram, and electromyography and nerve conduction studies may be somewhat useful to rule out bone, muscular, or vascular etiologies of the leg pain, an intracompartmental pressure measurement with a slit catheter revealing a pressure greater than 20 mm Hg is considered diagnostic of compartment syndrome. This patients sensory deficit (plantar foot paresthesia) points to tibial nerve compression and corresponding deep posterior compartment involvement.3
- Intracompartmental pressure measurement with slit catheter.
2. Edwards P, Myerson MS. Exertional compartment syndrome of the leg: steps for expedient return to activity. Phys Sports Med 1996;24:4-6.
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