Abstract Compartment pressure testing for exertional leg pain remains the gold standard for diagnosing chronic exertional compartment syndrome. To date nobody has documented an ultrasound guided standard protocol for ultrasound guided compartment testing. Musculoskeletal diagnostic ultrasound is a highly valuable, rapid and inexpensive tool in the armamentarium of the sports medicine physician. From 2008 to 2020, the principal author performed 235 compartment pressure tests with zero complications. A referral center for compartment pressure testing, 92.8% of tests were positive. Ultrasound anatomy of the lowe leg compartments can easily be mastered with practice. Once mastered by the sports medicine clinician, patients with chronic exertional compartment syndrome can be imaged with ultrasound in the office for ultrasound guided compartment pressure testing, ultrasound evaluation for compartment swelling with exercise, and treatment with ultrasound guided botulinum toxin injections. A standard reproducible protocol for ultrasound guided compartment pressure testing is described herein yielding zero complications by the author over a period of 20 years.
Keywords Chronic Exertional Compartment Syndrome; Exertional Leg Pain; Musculoskeletal Ultrasound; Ultrasound Guided; Compartment Pressure Test
Cite Silberman MR. Ultrasound Guided Compartment Pressure Test for Chronic Exertional Compartment Syndrome: A Standard Reproducible Protocol. Journal of Sports Medicine and Performance. Dec 2020; 1-16.
Key Points 1. Only two entry points are used for needle entry to test all four compartments of the lower leg.
2. The percentage of bilateral positive cases was 75.23%.
3. Ultrasound measurements of compartment size are taken pre and post exercise treadmill stress test for diagnosis and treatment decision making.
4. Treatment other than fasciotomy is discussed.
Competing Interests The author declares they have no competing interests.
Acknowledgement The author would like to thank Rebecca Silberman for assistance with compilation of the data, Susan Acero for assistance with computation of the data, and Kaitlin Anders, MS, ATC for assistance with creation of the images and figures.
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Exertional Compartment Syndrome Pressure Test