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Diagnosis of chronic exertional compartment syndrome by post-exercise MRI

OBJECTIVE: Chronic exertional compartment syndrome (CECS) is the cause of 27% of anterior leg pain in athletes. The source of pain in this condition is still debated. Measurement of intracompartmental pressure is the gold standard diagnosis, albeit an invasive study. The development and interpretati...

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Autores principales: Paús, Vicente, Graieb, Ariel, Torrengo, Federico, Villalba, Francisco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5318822/
http://dx.doi.org/10.1177/2325967117S00001
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author Paús, Vicente
Graieb, Ariel
Torrengo, Federico
Villalba, Francisco
author_facet Paús, Vicente
Graieb, Ariel
Torrengo, Federico
Villalba, Francisco
author_sort Paús, Vicente
collection PubMed
description OBJECTIVE: Chronic exertional compartment syndrome (CECS) is the cause of 27% of anterior leg pain in athletes. The source of pain in this condition is still debated. Measurement of intracompartmental pressure is the gold standard diagnosis, albeit an invasive study. The development and interpretation of new MRI sequences has provided a non-invasive alternative to CECS diagnosis. Post-exercise MRI is an attractive option, which is currently undergoing its validation process. METHODS: 22 patients with a clinical diagnosis of CECS were included, with a median follow-up of 5 years (1-10 years). All the patients were evaluated by clinical examination, pre- and post-exercise MRI and pre-and post-exercise intracompartmental pressure measurement. Pressure was measured with Whitesides technique, and diagnosis was carried out by Pedowitz criteria. RESULTS: Out of the total 22 patients, 19 had positive intracompartmental measurement (15 male, 4 female) and 3 had negative measurement. All the patients had a normal MRI at rest. The three patients who had negative intracompartmental measurement had a normal post-stress MRI. Out of the remaining 19 patients, the MRI detected hyperintense signal in T2 and STIR weighted in 15 of them (78,95%). CONCLUSIONS: MRI could be relevant for diagnosis, for which case the sensitivity of this method should be improved. Nevertheless, pre- and post-stress intracompartmental measurement continues to be the gold standard.
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spelling pubmed-53188222017-03-01 Diagnosis of chronic exertional compartment syndrome by post-exercise MRI Paús, Vicente Graieb, Ariel Torrengo, Federico Villalba, Francisco Orthop J Sports Med Article OBJECTIVE: Chronic exertional compartment syndrome (CECS) is the cause of 27% of anterior leg pain in athletes. The source of pain in this condition is still debated. Measurement of intracompartmental pressure is the gold standard diagnosis, albeit an invasive study. The development and interpretation of new MRI sequences has provided a non-invasive alternative to CECS diagnosis. Post-exercise MRI is an attractive option, which is currently undergoing its validation process. METHODS: 22 patients with a clinical diagnosis of CECS were included, with a median follow-up of 5 years (1-10 years). All the patients were evaluated by clinical examination, pre- and post-exercise MRI and pre-and post-exercise intracompartmental pressure measurement. Pressure was measured with Whitesides technique, and diagnosis was carried out by Pedowitz criteria. RESULTS: Out of the total 22 patients, 19 had positive intracompartmental measurement (15 male, 4 female) and 3 had negative measurement. All the patients had a normal MRI at rest. The three patients who had negative intracompartmental measurement had a normal post-stress MRI. Out of the remaining 19 patients, the MRI detected hyperintense signal in T2 and STIR weighted in 15 of them (78,95%). CONCLUSIONS: MRI could be relevant for diagnosis, for which case the sensitivity of this method should be improved. Nevertheless, pre- and post-stress intracompartmental measurement continues to be the gold standard. SAGE Publications 2017-01-31 /pmc/articles/PMC5318822/ http://dx.doi.org/10.1177/2325967117S00001 Text en © The Author(s) 2017 http://creativecommons.org/licenses/by-nc-nd/3.0/ This open-access article is published and distributed under the Creative Commons Attribution - NonCommercial - No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/3.0/), which permits the noncommercial use, distribution, and reproduction of the article in any medium, provided the original author and source are credited. You may not alter, transform, or build upon this article without the permission of the Author(s). For reprints and permission queries, please visit SAGE’s Web site at http://www.sagepub.com/journalsPermissions.nav.
spellingShingle Article
Paús, Vicente
Graieb, Ariel
Torrengo, Federico
Villalba, Francisco
Diagnosis of chronic exertional compartment syndrome by post-exercise MRI
title Diagnosis of chronic exertional compartment syndrome by post-exercise MRI
title_full Diagnosis of chronic exertional compartment syndrome by post-exercise MRI
title_fullStr Diagnosis of chronic exertional compartment syndrome by post-exercise MRI
title_full_unstemmed Diagnosis of chronic exertional compartment syndrome by post-exercise MRI
title_short Diagnosis of chronic exertional compartment syndrome by post-exercise MRI
title_sort diagnosis of chronic exertional compartment syndrome by post-exercise mri
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5318822/
http://dx.doi.org/10.1177/2325967117S00001
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