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The Role of Magnetic Resonance in the Diagnosis of Chronic Exertional Compartment Syndrome

Chronic compartment syndrome is a common and often underdiagnosed exercise-induced condition, accounting on average for a quarter of cases of chronic exertional pain in the leg, second only to the fracture/tibial stress syndrome spectrum. It traditionally occurs in young runner athletes, although mo...

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Autores principales: Nico, Marcelo Astolfi Caetano, Carneiro, Bruno Cerretti, Zorzenoni, Fernando Ometto, Ormond Filho, Alípio Gomes, Guimarães, Julio Brandão
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Thieme Revinter Publicações Ltda. 2020
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7748934/
https://www.ncbi.nlm.nih.gov/pubmed/33364643
http://dx.doi.org/10.1055/s-0040-1702961
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author Nico, Marcelo Astolfi Caetano
Carneiro, Bruno Cerretti
Zorzenoni, Fernando Ometto
Ormond Filho, Alípio Gomes
Guimarães, Julio Brandão
author_facet Nico, Marcelo Astolfi Caetano
Carneiro, Bruno Cerretti
Zorzenoni, Fernando Ometto
Ormond Filho, Alípio Gomes
Guimarães, Julio Brandão
author_sort Nico, Marcelo Astolfi Caetano
collection PubMed
description Chronic compartment syndrome is a common and often underdiagnosed exercise-induced condition, accounting on average for a quarter of cases of chronic exertional pain in the leg, second only to the fracture/tibial stress syndrome spectrum. It traditionally occurs in young runner athletes, although more recent studies have demonstrated a considerable prevalence in low-performance practitioners of physical activity, even in middle-aged or elderly patients. The list of differential diagnoses is extensive, and sometimes it is difficult to distinguish them only by the clinical data, and subsidiary examinations are required. The diagnosis is classically made by the clinical picture, by exclusion of the differential diagnoses, and through the measurement of the intracompartmental pressure. Although needle manometry is considered the gold standard in the diagnosis, its use is not universally accepted, since there are some important limitations, apart from the restricted availability of the needle equipment in Brazil. New protocols of manometry have recently been proposed to overcome the deficiency of the traditional ones, and some of them recommend the systematic use of magnetic resonance imaging (MRI) in the exclusion of differential diagnoses. The use of post-effort liquid-sensitive MRI sequences is a good noninvasive option instead of needle manometry in the diagnosis of chronic compartment syndrome, since the increase in post-exercise signal intensity is statistically significant when compared with manometry pressure values in asymptomatic patients and in those with the syndrome; hence, the test can be used in the diagnostic criteria. The definitive treatment is fasciotomy, although there are less effective alternatives.
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spelling pubmed-77489342020-12-22 The Role of Magnetic Resonance in the Diagnosis of Chronic Exertional Compartment Syndrome Nico, Marcelo Astolfi Caetano Carneiro, Bruno Cerretti Zorzenoni, Fernando Ometto Ormond Filho, Alípio Gomes Guimarães, Julio Brandão Rev Bras Ortop (Sao Paulo) Chronic compartment syndrome is a common and often underdiagnosed exercise-induced condition, accounting on average for a quarter of cases of chronic exertional pain in the leg, second only to the fracture/tibial stress syndrome spectrum. It traditionally occurs in young runner athletes, although more recent studies have demonstrated a considerable prevalence in low-performance practitioners of physical activity, even in middle-aged or elderly patients. The list of differential diagnoses is extensive, and sometimes it is difficult to distinguish them only by the clinical data, and subsidiary examinations are required. The diagnosis is classically made by the clinical picture, by exclusion of the differential diagnoses, and through the measurement of the intracompartmental pressure. Although needle manometry is considered the gold standard in the diagnosis, its use is not universally accepted, since there are some important limitations, apart from the restricted availability of the needle equipment in Brazil. New protocols of manometry have recently been proposed to overcome the deficiency of the traditional ones, and some of them recommend the systematic use of magnetic resonance imaging (MRI) in the exclusion of differential diagnoses. The use of post-effort liquid-sensitive MRI sequences is a good noninvasive option instead of needle manometry in the diagnosis of chronic compartment syndrome, since the increase in post-exercise signal intensity is statistically significant when compared with manometry pressure values in asymptomatic patients and in those with the syndrome; hence, the test can be used in the diagnostic criteria. The definitive treatment is fasciotomy, although there are less effective alternatives. Thieme Revinter Publicações Ltda. 2020-12 2020-04-02 /pmc/articles/PMC7748934/ /pubmed/33364643 http://dx.doi.org/10.1055/s-0040-1702961 Text en Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ) https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Nico, Marcelo Astolfi Caetano
Carneiro, Bruno Cerretti
Zorzenoni, Fernando Ometto
Ormond Filho, Alípio Gomes
Guimarães, Julio Brandão
The Role of Magnetic Resonance in the Diagnosis of Chronic Exertional Compartment Syndrome
title The Role of Magnetic Resonance in the Diagnosis of Chronic Exertional Compartment Syndrome
title_full The Role of Magnetic Resonance in the Diagnosis of Chronic Exertional Compartment Syndrome
title_fullStr The Role of Magnetic Resonance in the Diagnosis of Chronic Exertional Compartment Syndrome
title_full_unstemmed The Role of Magnetic Resonance in the Diagnosis of Chronic Exertional Compartment Syndrome
title_short The Role of Magnetic Resonance in the Diagnosis of Chronic Exertional Compartment Syndrome
title_sort role of magnetic resonance in the diagnosis of chronic exertional compartment syndrome
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7748934/
https://www.ncbi.nlm.nih.gov/pubmed/33364643
http://dx.doi.org/10.1055/s-0040-1702961
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