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exertional compartment syndrome

E Randy Eichner, Brock Schnebel, Scott Anderson, James R Clugston, Heath Hale, Charlie Michaudet, John M Small
We report 6 cases of a novel syndrome of acute, exertional low back pain (LBP) in football players, 5 in college and one in the National Football League (NFL). All 6 are African-Americans with sickle cell trait (SCT). The acute LBP is severe and can be disabling, and the condition can be confused with muscle strain, discogenic pain, stress fracture, or other problems in athletes. Our evidence shows that this syndrome is caused by lumbar paraspinal myonecrosis (LPSMN), which likely often contributes to the lumbar paraspinal compartment syndrome...
November 21, 2016: Medicine and Science in Sports and Exercise
Kristin L Garlanger, Elena J Jelsing, Jonathan T Finnoff
A 33-year-old elite female runner presented to a tertiary care sports medicine clinic with a 2-year history of progressive anterior thigh and circumferential leg pain with associated foot paresthesias brought on by high-intensity running. She had both external iliac artery vasospasm and chronic exertional compartment syndrome. External iliac artery vasospasm is a rare cause of exertional leg pain, particularly in the running population. This case highlights the unique features of this condition, addresses the multidisciplinary approach that led to the accurate diagnoses, and demonstrates that more than 1 etiology for exertional leg pain can coexist in an athlete...
October 19, 2016: Sports Health
Ilya Igolnikov, Matthew J Santiago, Kathryn T Gollotto
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Michael Drexler, T Frenkel Rutenberg, N Rozen, Y Warschawski, E Rath, O Chechik, G Rachevsky, G Morag
INTRODUCTION: Chronic exertional compartment syndrome (CECS) is a common injury in young athletes, causing pain in the involved leg compartment during strenuous exercise. The gold standard treatment is fasciotomy, but most of the reports on its effectiveness include relatively small cohorts and relatively short follow-up periods. This study reports the long-term results of a large cohort of young athletes who underwent single-incision fasciotomy for CECS. MATERIALS AND METHODS: This a retrospective case-series study...
September 26, 2016: Archives of Orthopaedic and Trauma Surgery
Daniel R Lueders, Jacob L Sellon, Jay Smith, Jonathan T Finnoff
BACKGROUND: Chronic exertional compartment syndrome (CECS) is a common cause of exertional leg pain. It is commonly treated with a surgical fasciotomy, which has a surgical complication rate of up to 16% and takes approximately 6-12 weeks to return to preprocedure activity levels. Therefore, the development of a less invasive, effective outpatient intervention to treat CECS is desirable. OBJECTIVE: To describe and validate an ultrasound-guided (USG) fasciotomy technique for the anterior and lateral compartments of the lower limb in an unembalmed cadaveric model...
September 14, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Mariëtte Z Meulekamp, Wieteke Sauter, Marieke Buitenhuis, Agali Mert, Peter van der Wurff
INTRODUCTION: Lower leg pain (LLP), including medial tibial stress syndrome (MTSS) and chronic exertional compartment syndrome (CECS), remains a major problem for the military. OBJECTIVE: Evaluation of patient characteristics and short-term results of the rehabilitation program for service members used in the Military Rehabilitation Centre Aardenburg. METHODS: This retrospective study includes 161 service members of the Netherlands Armed Forces...
September 2016: Military Medicine
Ekaterina Balaian, Claudia Schuster, Claudia Schönefeldt, Ulrich Germing, Detlef Haase, Sebastian Tuve, Rainer Ordemann, Gerhard Ehninger, Martin Bornhäuser, Uta Oelschlaegel, Brigitte Mohr, Malte von Bonin, Uwe Platzbecker, Martin Wermke
Lenalidomide (LEN) leads to erythroid improvement in the majority of patients with myelodysplastic syndrome and isolated deletion of the long arm of chromosome 5 (MDS-del(5q)). This effect is believed to be exerted via its immunomodulatory properties, although the precise nature is still incompletely understood. We prospectively performed immune profiling in the bone marrow and blood of MDS-del(5q) patients undergoing LEN therapy for a median of 6 cycles. Therapy with LEN led to a significant increase in the median absolute lymphocyte count (1...
October 2016: Annals of Hematology
Marialetizia Motta, Giovanni Chillemi, Valentina Fodale, Serena Cecchetti, Simona Coppola, Silvia Stipo, Viviana Cordeddu, Pompeo Macioce, Bruce D Gelb, Marco Tartaglia
SHOC2 is a scaffold protein composed almost entirely by leucine-rich repeats (LRRs) and having an N-terminal region enriched in alternating lysine and glutamate/aspartate residues (KEKE motifs). SHOC2 acts as positive modulator of the RAS-RAF-MEK-ERK signaling cascade by favoring stable RAF1 interaction with RAS. We previously reported that the p.Ser2Gly substitution in SHOC2 underlies Mazzanti syndrome, a RASopathy clinically overlapping Noonan syndrome, promoting N-myristoylation and constitutive targeting of the mutant to the plasma membrane...
July 27, 2016: Human Molecular Genetics
L Pegoli, A Pozzi, G Pivato
BACKGROUND: Chronic exertional compartment syndrome of the forearm is an uncommon condition, occurring in some populations such as athletes. The standard surgical treatment for professional athletes who cannot avoid trigger activity is an open forearm fasciotomy, which may require a long recovery time. The aim of this study is to present a new endoscopic single approach forearm fasciotomy technique and outcomes of at least 3 years follow up. METHODS: We performed the endoscopic single approach forearm fasciotomy in 4 forearms in 3 men with the mean age of 25 years...
February 2016: Journal of Hand Surgery Asian-Pacific Volume
Wes O Zimmermann, P H Helmhout, A Beutler
Overuse injuries of the leg are a common problem for young soldiers. This article reviews the literature concerning the prevention and treatment of exercise related leg pain in military settings and presents the latest developments in proposed mechanisms and treatments. Current practice and treatment protocols from the Dutch Armed Forces are reviewed, with an emphasis on the most prevalent conditions of medial tibial stress syndrome and chronic exertional compartment syndrome. The conclusion is that exercise related leg pain in the military is an occupational problem that deserves further study...
July 22, 2016: Journal of the Royal Army Medical Corps
Paolo Gisondi, Micol Del Giglio, Giampiero Girolomoni
Psoriasis is an immune-mediated inflammatory skin disease frequently associated with metabolic disorders, including diabetes, dyslipidaemia and metabolic syndrome. Moreover, a growing number of studies confirm the association between psoriasis and obesity. It has been found that obesity, as measured by body mass index >30 kg/m(2), can double the risk of incident psoriasis. A positive correlation between different measures of adiposity and the severity of psoriasis has also been reported. Epidemiologic studies have also provided robust evidence confirming the association between obesity and psoriatic arthritis...
December 2016: American Journal of Clinical Dermatology
Michiel B Winkes, Carroll M Tseng, Huub L Pasmans, Marike van der Cruijsen-Raaijmakers, Adwin R Hoogeveen, Marc R Scheltinga
BACKGROUND: A diagnosis of lower leg deep posterior chronic exertional compartment syndrome (dp-CECS) is made by a dynamic pressure measurement. The insertion of a pressure catheter is guided by anatomic landmarks (freehand) or by ultrasound. The catheter tip is ideally positioned in the tibialis posterior muscle (TP). The accuracy of in vivo catheter placement using lower leg magnetic resonance imaging (MRI) in healthy patients suspected of having dp-CECS has never been studied. PURPOSE: To analyze whether a freehand catheter insertion results in accurate positioning in the TP as confirmed by MRI in patients with suspected dp-CECS...
July 12, 2016: American Journal of Sports Medicine
Jennifer J Beck, Frances A Tepolt, Patricia E Miller, Lyle J Micheli, Mininder S Kocher
BACKGROUND: Chronic exertional compartment syndrome (CECS) is a cause of leg pain in running athletes and is treated with fasciotomy after failure of nonoperative management. CECS is being seen with increased frequency in younger patients. The demographics and outcomes of fasciotomy for CECS in pediatric patients, including risk factors for treatment failure, have not been described. PURPOSE: To describe characteristics of pediatric patients with CECS and determine surgical outcomes of the condition in this population...
June 30, 2016: American Journal of Sports Medicine
Sonia V Joubert, Manuel A Duarte
OBJECTIVE: The purpose of this case report is to describe a patient who presented with symptoms of exercise-induced compartment syndrome and was later referred for bilateral fasciotomy surgery. CLINICAL FEATURES: A 21-year-old patient presented for chiropractic care with the inability to run due to foot paresthesia and weakness. An exertion test and compartment pressure test diagnosed exercise-induced compartment syndrome. Exertion test and compartment pressure test were used to identify and diagnose exercise-induced compartment syndrome...
June 2016: Journal of Chiropractic Medicine
Mika J, Brinkmann O, Clanton To, Szalay G, Kinne Rw
INTRODUCTION: Only two cases of an isolated compartment syndrome of the extensor carpi ulnaris have been described previously [1,2]. In both cases, the onset was acute. In the first case, histological examination revealed no necrosis. The second case was regarded to be due to a previously unknown anatomic variation and no necrotic tissue was recognized upon gross examination. This case report describes a third case of an isolated acute exertional compartment syndrome (AECS) of the extensor carpi ulnaris muscle with focal areas of necrotic tissue...
January 2016: Journal of Orthopaedic Case Reports
Kristin S Livingston, William P Meehan, M Timothy Hresko, Travis H Matheney, Benjamin J Shore
OBJECTIVES: Acute exertional compartment syndrome (AECS) is a rare presentation of acute compartment syndrome (ACS) after exertion without injury. Unfamiliarity with this entity can lead to delay in diagnosis. The purpose of this study was to increase awareness of AECS and illustrate the morbidities associated with delayed diagnosis. METHODS: With institutional review board approval, we conducted a retrospective chart review of all patients who underwent emergent fasciotomies for AECS from 1997-2013 at our institution...
February 10, 2016: Pediatric Emergency Care
Nicola Maffulli, Mattia Loppini, Filippo Spiezia, Alessio D'Addona, Gayle D Maffulli
BACKGROUND: Chronic exertional compartment syndrome (CECS) involves a painful increase in compartment pressure caused by exercise and relieved by rest, common in athletes. The most common site for CECS in the lower limbs is the anterior leg compartment. The aim of this study is to evaluate the outcomes of a single minimal incision fasciotomy in athletes and their capability to return to high level sport activity. METHODS: The study reports mid-term results in a series of 18 consecutive athletes with chronic exertional compartment syndrome of the leg who had undergone minimally invasive fasciotomy...
2016: Journal of Orthopaedic Surgery and Research
Sathish Rajasekaran, Mederic M Hall
Although nonoperative treatment options for chronic exertional compartment syndrome (CECS) are often used in clinical practice, supporting evidence is limited. The objective of this study was to systematically review the literature for nonsurgical treatment options for CECS of the lower leg. The literature search identified seven articles describing in total four different treatment options: massage, gait changes, chemodenervation, and ultrasound-guided (USG) fascial fenestration. Pertinent studies were in the form of case series and one case report, which limited the robustness of the data...
May 2016: Current Sports Medicine Reports
Michiel B Winkes, Joep A Teijink, Marc R Scheltinga
We discuss a case of a 26-year-old man, a motorcycle racer, who presented with progressive pain, weakness and swelling of his right forearm and loss of power in his index finger, experienced during motor racing. Chronic exertional compartment syndrome (CECS) of both flexor and extensor compartments of his forearm was diagnosed by dynamic intracompartmental muscle pressure measurements. After fasciotomies, all symptoms were resolved and the patient was able to improve on his preinjury racing skills, without any limitations...
2016: BMJ Case Reports
Dominic Campano, Jose A Robaina, Nicholas Kusnezov, John C Dunn, Brian R Waterman
PURPOSE: To review published literature to characterize the at-risk demographic, operative indications, surgical techniques, functional outcomes, and reoperation and complication rates after operative management of chronic exertional compartment syndrome (CECS) of the lower leg. METHODS: We searched PubMed, Embase, Cochrane Database, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) through February 1, 2015, using the terms "chronic exertional" and/or "exercise induced compartment syndrome...
July 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
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