IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Chronic exertional compartment syndrome

Case contributed by Bruno Lorensini
Diagnosis certain

Presentation

An amateur athlete with pain in the lower legs, predominantly on the left, when exercising. Relief of symptoms when stopping the exercise.

Patient Data

Age: 25 years
Gender: Male

MRI Legs (before exercise)

mri

Axial T1 and STIR show normal structures bilaterally without evidence of muscle edema, interstitial fluid or focal abnormality.

Marker on the skin indicates painful site.

MRI Legs (after exercise)

mri

We ask the patient to perform physical activity in which shows the pain (running).

After starting with the symptoms a new scan was performed.

STIR after stress show signal intensity of the muscles in the anterior compartments bilaterally consistent with muscle edema. 

MRI Legs comparison pre &...

mri

MRI Legs comparison pre & after exercise

Left: Coronal T1 - to reference.

Upper right: Axial STIR - before stress

Lower right: Axial STIR - after stress

Case Discussion

This is a typical case of chronic exertional anterior compartment syndrome in both legs.

The main differential diagnoses of muscle edema:

None of these cases have normal MRI and edema only after stress.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.