J Korean Soc Radiol.  2013 Jan;68(1):57-61.

Idiopathic Acute Isolated Lateral Compartment Syndrome of a Lower Leg: A Magnetic Resonance Imaging Case Report

• Yeom DH
• Lee J
• Cho WH
• Kim JH
• Jeong MJ
• Kim SH
• Kim JY
• Kim SH
• Kang MJ
• Lee HB
• Bae KE

Abstract

Acute compartment syndrome of the lower leg is usually associated with major trauma such as fracture, and most commonly occurs in the anterior or deep posterior compartments. Isolated lateral compartment syndrome is less typical and usually associated with minor trauma or exertion. There are a few reports of the acute compartment syndrome which develops without an obvious cause. However, there are few reports of idiopathic acute isolated lateral compartment syndrome, and there are no reports of the radiologic findings. This study presents a radiologic finding of idiopathic acute isolated lateral compartment of lower leg, which shows localized enlargement of the peroneal muscles with peripheral convex bowing and change of their signal intensity with fluid signal along the adjacent fascial planes on magnetic resonance imaging.

MeSH Terms

Compartment Syndromes
Leg
Magnetic Resonance Imaging
Magnetic Resonance Spectroscopy
Magnetics
Magnets
Muscles

Figure

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  Fig. 1 Idiopathic acute isolated lateral compartment syndrome of a lower leg in a 48-year-old female. Axial T1-weighted image of lower leg shows marked swelling of the peroneus longus and brevis muscles with peripheral convex bowing (arrow) (A). Axial and coronal fat-suppressed T2-weighted image show diffuse high signal intensity of the peroneus longus and brevis muscles (long arrows) (B, C). Also the fluid signal intensity is noted within the surrounding deep and superficial fascial planes (arrowheads) (B, C). Focal increased signal intensity suspected reactive change is noted in the extensor digitorum longus and soleus muscles around the peroneus longus muscle (short arrows) (B). Axial gadolinium-enhanced T1-weighted image shows heterogeneous enhancement within the affected muscles of the lateral compartment (arrow) (D).

Reference

1. Oh LS, Lewis PB, Prasarn ML, Lorich DG, Helfet DL. Painless, atraumatic, isolated lateral compartment syndrome of the leg: an unusual triad of atypical findings. Am J Orthop (Belle Mead NJ). 2010. 39:35–39.

2. Ashton LA, Jarman PG, Marel E. Peroneal compartment syndrome of non-traumatic origin: a case report. J Orthop Surg (Hong Kong). 2001. 9:67–69.

3. Rehman S, Joglekar SB. Acute isolated lateral compartment syndrome of the leg after a noncontact sports injury. Orthopedics. 2009. 32:523.

4. Gourgiotis S, Villias C, Germanos S, Foukas A, Ridolfini MP. Acute limb compartment syndrome: a review. J Surg Educ. 2007. 64:178–186.

5. Jose RM, Viswanathan N, Aldlyami E, Wilson Y, Moiemen N, Thomas R. A spontaneous compartment syndrome in a patient with diabetes. J Bone Joint Surg Br. 2004. 86:1068–1070.

6. Pearse MF, Harry L, Nanchahal J. Acute compartment syndrome of the leg. BMJ. 2002. 325:557–558.

7. Verleisdonk EJ, van Gils A, van der Werken C. The diagnostic value of MRI scans for the diagnosis of chronic exertional compartment syndrome of the lower leg. Skeletal Radiol. 2001. 30:321–325.

8. Lauder TD, Stuart MJ, Amrami KK, Felmlee JP. Exertional compartment syndrome and the role of magnetic resonance imaging. Am J Phys Med Rehabil. 2002. 81:315–319.

9. May DA, Disler DG, Jones EA, Balkissoon AA, Manaster BJ. Abnormal signal intensity in skeletal muscle at MR imaging: patterns, pearls, and pitfalls. Radiographics. 2000. 20 Spec No:S295–S315.