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Compartment Syndrome and Muscle Herniation
Andrew Sonin, MD, FACR; Donna G. Blankenbaker, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Compartment syndrome (CS)
            • Synonyms

              • Acute compartment syndrome
              • Chronic (exertional) compartment syndrome (exertional CS, recurrent CS, subacute CS)
            • Definitions

              • Condition in which perfusion pressure falls below tissue pressure in closed anatomic space
              • Damage to soft tissues within anatomically confined space resulting from elevated pressure within that space

            IMAGING

            • General Features

              • MR Findings

                • Imaging Recommendations

                  • Ultrasonographic Findings

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Staging, Grading, & Classification

                          • Gross Pathologic & Surgical Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        • Reporting Tips

                                          Selected References

                                          1. Via AG et al: Acute compartment syndrome. Muscles Ligaments Tendons J. 5(1):18-22, 2015
                                          2. Kramer DE et al: Diagnosis and management of symptomatic muscle herniation of the extremities: a retrospective review. Am J Sports Med. 41(9):2174-80, 2013
                                          3. Rajasekaran S et al: The utility of ultrasound in detecting anterior compartment thickness changes in chronic exertional compartment syndrome: a pilot study. Clin J Sport Med. 23(4):305-11, 2013
                                          4. Ringler MD et al: MRI accurately detects chronic exertional compartment syndrome: a validation study. Skeletal Radiol. 42(3):385-92, 2013
                                          5. Sigmund EE et al: Stimulated echo diffusion tensor imaging and SPAIR T(2) -weighted imaging in chronic exertional compartment syndrome of the lower leg muscles. J Magn Reson Imaging. Epub ahead of print, 2013
                                          6. Andreisek G et al: T2*-weighted and arterial spin labeling MRI of calf muscles in healthy volunteers and patients with chronic exertional compartment syndrome: preliminary experience. AJR Am J Roentgenol. 193(4):W327-33, 2009
                                          7. Baker JF et al: Foot drop--an unusual presentation of exertional compartment syndrome. Clin J Sport Med. 19(3):236-7, 2009
                                          8. Gielen JL et al: Chronic exertional compartment syndrome of the forearm in motocross racers: findings on MRI. Skeletal Radiol. 38(12):1153-61, 2009
                                          9. Liu HL et al: Gluteal compartment syndrome after prolonged immobilisation. Asian J Surg. 32(2):123-6, 2009
                                          10. McCaffrey DD et al: Acute compartment syndrome of the anterior thigh in the absence of fracture secondary to sporting trauma. J Trauma. 66(4):1238-42, 2009
                                          11. Brey JM et al: Salvage of compartment syndrome of the leg and foot. Foot Ankle Clin. 13(4):767-72, 2008
                                          12. Farr D et al: Chronic exertional compartment syndrome in a collegiate soccer player: a case report and literature review. Am J Orthop. 37(7):374-7, 2008
                                          13. Halanski M et al: Cast and splint immobilization: complications. J Am Acad Orthop Surg. 16(1):30-40, 2008
                                          14. Shadgan B et al: Diagnostic techniques in acute compartment syndrome of the leg. J Orthop Trauma. 22(8):581-7, 2008
                                          15. Dhawan SS et al: Four-extremity gangrene associated with crack cocaine abuse. Ann Emerg Med. 49(2):186-9, 2007
                                          16. Konstantakos EK et al: Diagnosis and management of extremity compartment syndromes: an orthopaedic perspective. Am Surg. 73(12):1199-209, 2007
                                          17. Armfield DR et al: Sports-related muscle injury in the lower extremity. Clin Sports Med. 25(4):803-42, 2006
                                          18. Beraldo S et al: Lower limb acute compartment syndrome after colorectal surgery in prolonged lithotomy position. Dis Colon Rectum. 49(11):1772-80, 2006
                                          19. Woolley SL et al: Acute compartment syndrome secondary to diabetic muscle infarction: case report and literature review. Eur J Emerg Med. 13(2):113-6, 2006
                                          20. Olson SA et al: Acute compartment syndrome in lower extremity musculoskeletal trauma. J Am Acad Orthop Surg. 13(7):436-44, 2005
                                          21. Kostler W et al: Acute compartment syndrome of the limb. Injury. 35(12):1221-7, 2004
                                          22. Pell RF 4th et al: Leg pain in the running athlete. J Am Acad Orthop Surg. 12(6):396-404, 2004
                                          23. Rominger MB et al: MR imaging of compartment syndrome of the lower leg: a case control study. Eur Radiol. 14(8):1432-9, 2004
                                          24. Beggs I: Sonography of muscle hernias. AJR Am J Roentgenol. 180(2):395-9, 2003
                                          25. Mellado JM et al: Muscle hernias of the lower leg: MRI findings. Skeletal Radiol. 28(8):465-9, 1999
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Pathology

                                                  • Clinical Issues

                                                    TERMINOLOGY

                                                    • Abbreviations

                                                      • Compartment syndrome (CS)
                                                    • Synonyms

                                                      • Acute compartment syndrome
                                                      • Chronic (exertional) compartment syndrome (exertional CS, recurrent CS, subacute CS)
                                                    • Definitions

                                                      • Condition in which perfusion pressure falls below tissue pressure in closed anatomic space
                                                      • Damage to soft tissues within anatomically confined space resulting from elevated pressure within that space

                                                    IMAGING

                                                    • General Features

                                                      • MR Findings

                                                        • Imaging Recommendations

                                                          • Ultrasonographic Findings

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Staging, Grading, & Classification

                                                                  • Gross Pathologic & Surgical Features

                                                                    CLINICAL ISSUES

                                                                    • Presentation

                                                                      • Demographics

                                                                        • Natural History & Prognosis

                                                                          • Treatment

                                                                            DIAGNOSTIC CHECKLIST

                                                                            • Consider

                                                                              • Image Interpretation Pearls

                                                                                • Reporting Tips

                                                                                  Selected References

                                                                                  1. Via AG et al: Acute compartment syndrome. Muscles Ligaments Tendons J. 5(1):18-22, 2015
                                                                                  2. Kramer DE et al: Diagnosis and management of symptomatic muscle herniation of the extremities: a retrospective review. Am J Sports Med. 41(9):2174-80, 2013
                                                                                  3. Rajasekaran S et al: The utility of ultrasound in detecting anterior compartment thickness changes in chronic exertional compartment syndrome: a pilot study. Clin J Sport Med. 23(4):305-11, 2013
                                                                                  4. Ringler MD et al: MRI accurately detects chronic exertional compartment syndrome: a validation study. Skeletal Radiol. 42(3):385-92, 2013
                                                                                  5. Sigmund EE et al: Stimulated echo diffusion tensor imaging and SPAIR T(2) -weighted imaging in chronic exertional compartment syndrome of the lower leg muscles. J Magn Reson Imaging. Epub ahead of print, 2013
                                                                                  6. Andreisek G et al: T2*-weighted and arterial spin labeling MRI of calf muscles in healthy volunteers and patients with chronic exertional compartment syndrome: preliminary experience. AJR Am J Roentgenol. 193(4):W327-33, 2009
                                                                                  7. Baker JF et al: Foot drop--an unusual presentation of exertional compartment syndrome. Clin J Sport Med. 19(3):236-7, 2009
                                                                                  8. Gielen JL et al: Chronic exertional compartment syndrome of the forearm in motocross racers: findings on MRI. Skeletal Radiol. 38(12):1153-61, 2009
                                                                                  9. Liu HL et al: Gluteal compartment syndrome after prolonged immobilisation. Asian J Surg. 32(2):123-6, 2009
                                                                                  10. McCaffrey DD et al: Acute compartment syndrome of the anterior thigh in the absence of fracture secondary to sporting trauma. J Trauma. 66(4):1238-42, 2009
                                                                                  11. Brey JM et al: Salvage of compartment syndrome of the leg and foot. Foot Ankle Clin. 13(4):767-72, 2008
                                                                                  12. Farr D et al: Chronic exertional compartment syndrome in a collegiate soccer player: a case report and literature review. Am J Orthop. 37(7):374-7, 2008
                                                                                  13. Halanski M et al: Cast and splint immobilization: complications. J Am Acad Orthop Surg. 16(1):30-40, 2008
                                                                                  14. Shadgan B et al: Diagnostic techniques in acute compartment syndrome of the leg. J Orthop Trauma. 22(8):581-7, 2008
                                                                                  15. Dhawan SS et al: Four-extremity gangrene associated with crack cocaine abuse. Ann Emerg Med. 49(2):186-9, 2007
                                                                                  16. Konstantakos EK et al: Diagnosis and management of extremity compartment syndromes: an orthopaedic perspective. Am Surg. 73(12):1199-209, 2007
                                                                                  17. Armfield DR et al: Sports-related muscle injury in the lower extremity. Clin Sports Med. 25(4):803-42, 2006
                                                                                  18. Beraldo S et al: Lower limb acute compartment syndrome after colorectal surgery in prolonged lithotomy position. Dis Colon Rectum. 49(11):1772-80, 2006
                                                                                  19. Woolley SL et al: Acute compartment syndrome secondary to diabetic muscle infarction: case report and literature review. Eur J Emerg Med. 13(2):113-6, 2006
                                                                                  20. Olson SA et al: Acute compartment syndrome in lower extremity musculoskeletal trauma. J Am Acad Orthop Surg. 13(7):436-44, 2005
                                                                                  21. Kostler W et al: Acute compartment syndrome of the limb. Injury. 35(12):1221-7, 2004
                                                                                  22. Pell RF 4th et al: Leg pain in the running athlete. J Am Acad Orthop Surg. 12(6):396-404, 2004
                                                                                  23. Rominger MB et al: MR imaging of compartment syndrome of the lower leg: a case control study. Eur Radiol. 14(8):1432-9, 2004
                                                                                  24. Beggs I: Sonography of muscle hernias. AJR Am J Roentgenol. 180(2):395-9, 2003
                                                                                  25. Mellado JM et al: Muscle hernias of the lower leg: MRI findings. Skeletal Radiol. 28(8):465-9, 1999