Compartment Syndrome - Diagnosis

Describe the events that led to a diagnosis of compartment syndrome.

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How is compartment syndrome diagnosed?

While it is uncommon, the health care practitioner has to have a high index of suspicion for acute compartment syndrome if a patient presents with excessive pain, numbness, and a tense extremity after an injury. The patient's history of an injury to the extremity often is all that is necessary for a diagnosis.

While blood tests may be ordered to look for chemical markers of muscle injury (for example, myoglobin and lactate levels) and kidney damage, the definitive diagnosis of compartment syndrome is confirmed by measuring the pressure within the compartments of the affected limb. A sterile needle is inserted directly into the muscle compartment and attached to a pressure monitoring device (see second-last reference for picture). Usually, pressure measurements (see values listed above) are taken in each compartment in the affected limb and this may require multiple needle sticks.

Chronic compartment syndrome may be diagnosed clinically but compartment pressures may be measured before and after exercise to confirm the diagnosis. The health care professional should also explore other potential causes of pain due to exercise, including stress fractures, shin splints, or tendon inflammation.

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