From the University of Maryland Medical Center (Dr. Shaw, Dr. Kish, and Dr. Pensy) and the R. Adams Cowley Shock Trauma Center, Baltimore, MD (Dr. Shaw, Dr. Kish, and Dr. Pensy).
J Am Acad Orthop Surg Glob Res Rev. 2022 Jun 2;6(6). doi: 10.5435/JAAOSGlobal-D-21-00228. eCollection 2022 Jun 1.
Acute hematogenous osteomyelitis is well described after minor trauma in the pediatric population, with an incidence of 1 to 13 cases per 100,000 individuals. Compartment syndrome (CS) in children is a rare, but potentially devastating disease, classified as "cannot miss diagnosis." Compared with adults, CS may exhibit a variable presentation with a wide range of symptoms in children, often leading to delayed diagnosis. Expeditious diagnosis and treatment of CS is paramount in minimizing adverse sequelae and maximizing potential functional outcome, regardless of etiology. Here, we present a rare case of atraumatic CS resulting from ruptured subperiosteal abscess secondary to acute hematogenous osteomyelitis in a pediatric male patient with 2 weeks of forearm pain and evolving neurologic deficits with initial delay in presentation to our facility. The ramifications of delayed diagnosis or misdiagnosis of CS emphasize the importance of a high index of suspicion despite atypical presentations in the pediatric patient.
儿童轻微创伤后常发生急性血源性骨髓炎，发病率为每 10 万人中有 1 至 13 例。儿童的筋膜间室综合征（CS）是一种罕见但潜在破坏性的疾病，被归类为“不能漏诊的疾病”。与成人相比，CS 在儿童中可能表现出不同的表现，症状范围广泛，常导致诊断延迟。无论病因如何，迅速诊断和治疗 CS 对于最大限度地减少不良后果和最大限度地发挥潜在功能结果至关重要。在这里，我们介绍了一例罕见的无创伤性 CS 病例，该病例是由急性血源性骨髓炎引起的骨膜下脓肿破裂导致的，该患儿为男性，前臂疼痛 2 周，神经功能逐渐受损，最初在我院就诊时出现延迟。CS 的诊断延迟或误诊的后果强调了尽管在儿科患者中表现不典型，仍要高度怀疑该病。
