Acute compartment syndrome with myonecrosis is a rare complication of contrast media extravasation ^1-3 and lead to an eventful hospital course in this patient after a polytrauma CT.

Imaging findings indicating compartment syndrome ^4-6:

• increased muscular volume with fascial bowing
• muscle edema and hemorrhage
• central hypoperfusion and peripheral contrast enhancement indicating myonecrosis

The patient had an emergency fasciotomy, which confirmed myonecrosis of the extensor pollicis brevis and extensor digitorum muscles and subsequent debridement and further muscle biopsy specimens were taken. A second look operation thereafter did not show any further areas of necrosis. Eventually, the patient recovered without any functional deficit of the forearm.