Chronic Exertional Compartment Syndrome in a Fire Captain

Chronic exertional compartment syndrome (CECS) is a commonly missed diagnosis. It is caused by an increase in intramuscular pressure which subsequently impedes local tissue perfusion and function. It disproportionately occurs in young females; however, the diagnosis should not be excluded in other demographics. We present a case of CECS in an otherwise healthy 53-year-old male fire captain. He presented with pain upon exertion and neurological deficits in the anterior compartment of his bilateral legs that impacted his occupation and daily functioning. Following fasciotomy, the patient returned to work with complete resolution of pain and neurological deficits. This review seeks to describe the prevalence, etiology, diagnostic criteria, differential diagnosis, and management of CECS of the lower extremities, as described in the literature.