Badenhorst Jacques, Velleman Mark, van Rensburg Audrey Jansen, Botha Tanita, van der Walt Nikki, van Rensburg Christa Janse
Department of Diagnostic Radiology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
Radiologist, Private Practice, Capital Radiology, Pretoria, South Africa.
SA J Radiol. 2021 Oct 6;25(1):2219. doi: 10.4102/sajr.v25i1.2219. eCollection 2021.
Chronic exertional compartment syndrome (CECS) of the forearm is a rare but important cause of morbidity amongst athletes involved in strenuous upper limb activities. The diagnosis remains challenging due to the absence of objective, reproducible diagnostic studies.
To assess and quantify signal intensity (SI) changes of involved muscles in patients with CECS of the forearm compared to healthy control subjects competing in similar sporting disciplines. Also, to objectively measure MRI SIs within muscle compartments when using a pre- and post-exercise regime and calculating a signal intensity ratio (SIR) between post- and pre-exercise studies.
The study retrospectively examined MRI scans of patients treated for CECS of the forearm and compared these to the MRI scans of asymptomatic high-level rowers. A specific, reproducible pre- and post-exercise MRI scanning protocol was utilised in both patient and control subjects between 2011 and 2020. Signal intensities were evaluated pre- and post-exercise in involved muscle groups and ratios were calculated.
A total of 86 SIs were measured (43 pre- and 43 post-exercise) in nine study participants (five patients and four controls). After post:pre-exercise comparisons, a statistically significant difference was found between control and patient groups ( = 0.0010). The extensor carpi radialis, flexor digitorum profundus and flexor digitorum superficialis muscles were most commonly involved.
This study confirms that significant SI changes are apparent in patients with CECS of the forearm when making use of a standardised pre- and post-exercise MRI protocol. Furthermore, SIR may be used to accurately diagnose CECS of the forearm.
前臂慢性运动性骨筋膜室综合征（CECS）在从事剧烈上肢活动的运动员中是一种罕见但重要的发病原因。由于缺乏客观、可重复的诊断研究，诊断仍然具有挑战性。
评估和量化前臂CECS患者受累肌肉的信号强度（SI）变化，并与参加类似体育项目的健康对照者进行比较。此外，在采用运动前和运动后方案时，客观测量肌肉骨筋膜室内的MRI信号强度，并计算运动后与运动前研究之间的信号强度比（SIR）。
该研究回顾性检查了接受前臂CECS治疗患者的MRI扫描，并将其与无症状高水平划船运动员的MRI扫描进行比较。在2011年至2020年期间，患者和对照者均采用了特定的、可重复的运动前和运动后MRI扫描方案。对受累肌肉组在运动前和运动后的信号强度进行评估，并计算比值。
在9名研究参与者（5名患者和4名对照者）中总共测量了86个信号强度（运动前43个，运动后43个）。运动后与运动前比较后，发现对照组和患者组之间存在统计学显著差异（=0.0010）。桡侧腕伸肌、指深屈肌和指浅屈肌最常受累。
本研究证实，采用标准化的运动前和运动后MRI方案时，前臂CECS患者存在明显的SI变化。此外，SIR可用于准确诊断前臂CECS。
