Kettering General Hospital, NHS, Kettering, UK.
National Hospital of Sri Lanka, Colombo, Sri Lanka.
J Med Case Rep. 2021 Mar 3;15(1):100. doi: 10.1186/s13256-021-02683-y.
Acutely painful lower limb is a common presentation to the emergency department, and acute compartment syndrome is an important differential diagnosis to consider given the correct predisposing history and clinical presentation. However, idiopathic spontaneous compartment syndrome is an uncommon occurrence.
A 54-year-old Caucasian man with no previous comorbidities presented with acute right-sided lower limb pain with classical symptoms showing gradual evolution. He had no other history of medical relevance and no preceding injury. Examination showed a marginally enlarged right lower limb with stretched skin and tenderness. Routine blood tests were normal including D-dimer levels. However, in the absence of any underlying risk factors, acute compartment syndrome was suspected on clinical merit and confirmed with magnetic resonance imaging. He underwent successful surgical intervention with fasciotomy and achieved good recovery.
Acute compartment syndrome, though commonly attributed to trauma, can occur due to varied causes. Spontaneous acute compartment syndrome is attributed to diabetes mellitus. Idiopathic acute spontaneous compartment syndrome occurs in the absence of either intrinsic or extrinsic risk factors and is rarely documented in the literature. This case highlights the importance of appreciating classical clinical signs and having the clinical acumen to consider an obvious diagnosis even in its rarer form of presentation.
急性下肢剧痛是急诊科常见的表现，考虑到正确的诱发病史和临床表现，急性间隔综合征是一个重要的鉴别诊断。然而，特发性自发性间隔综合征并不常见。
一位 54 岁的白人男性，无既往合并症，表现为急性右侧下肢疼痛，具有典型的逐渐加重的症状。他没有其他相关病史，也没有先前的损伤。检查显示右侧下肢略肿大，皮肤紧绷，有压痛。常规血液检查正常，包括 D-二聚体水平。然而，由于没有任何潜在的危险因素，根据临床依据怀疑为急性间隔综合征，并通过磁共振成像得到证实。他接受了成功的手术干预，包括筋膜切开术，并恢复良好。
急性间隔综合征虽然通常归因于创伤，但也可能由多种原因引起。自发性急性间隔综合征归因于糖尿病。特发性急性自发性间隔综合征发生在没有内在或外在危险因素的情况下，在文献中很少有记录。本病例强调了重视经典临床体征的重要性，并具有敏锐的临床洞察力，即使在罕见的表现形式下，也要考虑到明显的诊断。
