Rattan Bishum, Misser Shalendra K
Lake Smit and Partners Inc., Durban, South Africa.
School of Health Sciences, University of KwaZulu-Natal, South Africa.
SA J Radiol. 2018 Apr 18;22(1):1284. doi: 10.4102/sajr.v22i1.1284. eCollection 2018.
Exercise-related limb pain poses a management dilemma to the clinician. The term 'chronic exertional compartment syndrome' (CECS) (previously known as 'anterior tibial syndrome') refers to a condition characterised by exercise-induced pain in one or more muscle groups and is more commonly seen in the lower limbs. Much less has been reported about the upper limbs where the muscular compartments are variably noted to be involved. A high index of clinical suspicion should therefore be maintained to avoid missing the diagnosis. Although commonly noted in athletes, CECS can occur in any age group with any level of exercise activity. In addition, there is no age predilection and the syndrome may be bilateral. The exact prevalence is not known as many athletes modify their training methods, thus delaying or avoiding medical assistance and imaging. The pathophysiology of compartment syndrome is complex. In this review of the syndrome, we describe the cycle of intracellular events leading to CECS and the eventual destruction of muscle. There is considerable overlap with the many possible causes of limb pain. Even the most experienced clinicians experience some difficulty in making this diagnosis of CECS, but with increasing awareness of this entity and availability of good-quality magnetic resonance imaging to confirm the suspicion, upper limb CECS is being more commonly diagnosed and patients more timeously managed.
与运动相关的肢体疼痛给临床医生带来了管理难题。“慢性运动性骨筋膜室综合征”（CECS）（以前称为“胫前综合征”）是指一种以运动诱发一个或多个肌肉群疼痛为特征的病症，在下肢更为常见。关于上肢的报道则少得多，上肢的肌肉骨筋膜室不同程度地被发现受累。因此，应保持高度的临床怀疑，以免漏诊。虽然CECS常见于运动员，但它可发生于任何年龄组、任何运动水平的人群。此外，该综合征无年龄倾向，且可能双侧发病。由于许多运动员会改变训练方法，从而延迟或避免寻求医疗帮助和进行影像学检查，因此确切的患病率尚不清楚。骨筋膜室综合征的病理生理学很复杂。在对该综合征的综述中，我们描述了导致CECS的细胞内事件循环以及肌肉的最终破坏。肢体疼痛有许多可能的原因，二者存在相当多的重叠。即使是最有经验的临床医生在诊断CECS时也会遇到一些困难，但随着对该病症的认识不断提高以及高质量磁共振成像技术的应用以证实怀疑，上肢CECS的诊断越来越普遍，患者也能得到更及时的治疗。
