What are clinical signs of contrast extravasation?
Typical clinical signs are pain, tenderness and swelling, itching, skin discolouration and oedema.
What are complications of contrast extravasation?
Complications include skin ulceration, soft tissue necrosis, compartment syndrome and very rarely limb ischaemia.
What are conservative therapeutic measures to treat contrast media extravasation?
Conservative therapeutic measures include an aspiration attempt as long the catheter is still in place, elevation of the affected limb and cooling. Application of different ointments and topical methods are used depending on department policy.
What are MRI findings in compartment syndrome?
Imaging findings include an increase in muscular volume with bulging of the compartment, muscle oedema and haemorrhage and after contrast administration peripheral enhancement with central hypoperfusion.
Findings:
Widespread subcutaneous oedema of the dorsal forearm.
Volume increase and muscle oedema of the muscles within the extensor compartment, especially the abductor and extensor pollicis brevis and longus as well as extensor digitorum and extensor carpi ulnaris muscles.
There is also hyperintensity in T1w images as an indicator for intramuscular haemorrhage and peripheral contrast enhancement of the above-mentioned muscles in the extensor compartment of the forearm.
Unremarkable osseous structures. Normal radial and ulnar artery.
Impression:
Compartment syndrome in the extensor compartment of the forearm after contrast media extravasation.