Chronic exertional compartment syndrome

Case contributed by Dr Bruno Lorensini

Presentation

Amateur athlete with pain in the lower legs, predominantly on the left, when exercising. Relief of symptoms when stop the exercise.

Patient Data

Age: 24-year-old
Gender: Male
MRI

MRI Legs (before exercise)

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

Marker on the skin indicate painful site.

MRI

MRI Legs (after exercise)

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 oedema. 

MRI

MRI Legs (comparison pre and 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 oedema:

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

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Case information

rID: 43615
Case created: 19th Mar 2016
Last edited: 9th Oct 2016
Inclusion in quiz mode: Included

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