Compartment syndrome

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Wrist anatomy

The hallmark symptom of compartment syndrome is severe pain that does not respond to elevation or pain medication. In more advanced cases, there may be decreased sensation, weakness, and paleness of the skin.

Typically, severe pain will occur when a muscle running through a compartment is passively moved. For example, when the doctor moves the toes up and down, a patient with compartment syndrome in the foot or lower leg will experience severe pain. The skin overlying the compartment will be tensely swollen and shiny. There will also be pain when the compartment is squeezed.

The test that will absolutely diagnose this condition involves directly measuring the pressure in the compartment by inserting a needle attached to a pressure meter into the compartment. When the compartment pressure is greater than 45 mmHg or when the pressure is within 30 mmHg of the diastolic blood pressure (the lower number of the blood pressure), then the diagnosis is made. When chronic compartment syndrome is suspected, this test must be performed immediately after the activity that causes pain.

Review Date: 09/26/2006
Reviewed By: Andrew L. Chen, M.D., M.S., Orthopedist, The Alpine Clinic, Littleton, NH. Review provided by VeriMed Healthcare Network.