title: The utility of ultrasound in detecting anterior compartment thickness changes in chronic exertional compartment syndrome: a pilot study.
abstract: OBJECTIVE
  To test the hypothesis that patients with chronic exertional compartment syndrome (CECS) of the anterior leg compartment have an increased anterior compartment thickness (ACT) compared with control subjects after exertion using ultrasound.
  
  
  METHODS
  Prospective comparison study.
  
  
  METHODS
  Diagnostic imaging department of a tertiary care hospital.
  
  
  METHODS
  Four patients with CECS and 9 control subjects.
  
  
  METHODS
  Patients with CECS and control subjects ran on a treadmill for up to 10 minutes. Anterior compartment thickness (both groups) and anterior compartment pressure (CECS patients) were measured before exertion and at scheduled intervals after exertion.
  
  
  METHODS
  Anterior compartment thickness, percentage change in ACT from rest, and compartment pressure.
  
  
  RESULTS
  Anterior compartment pressures were diagnostic of CECS using the modified Pedowitz criteria in patients with CECS. Mean percentage change in ACT from rest in patients with CECS versus control subjects at 0.5 minutes was 21.3% versus 6.32% [95% confidence interval (CI), 6.92-35.6 and 0.094-12.5, respectively; P = 0.011]; at 2.5 minutes, it was 24.6% versus 4.22% (95% CI, 10.7-38.5 and -1.85-10.3, respectively; P = 0.003); and at 4.5 minutes, it was 24.9% versus 5.08% (95% CI, 14.3-35.5 and -0.813-11.0, respectively; P = 0.003). Mean ACT in patients with CECS versus control subjects significantly increased after exertion (P = 0.003) at 0.5 minutes, 2.5 minutes, and 4.5 minutes.
  
  
  CONCLUSIONS
  Ultrasonography reveals a significant increase in ACT in patients with CECS of the anterior leg compartment. Further studies are warranted to validate these findings with the goal of developing anterior leg compartment CECS ultrasound diagnostic criteria and exploring the role of using ultrasound to diagnose CECS in other compartments.
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Saskatchewan, Saskatoon, Canada. sathish.k.rajasekaran@gmail.com
authors.forename: Sathish
authors.initials: S
authors.lastname: Rajasekaran
authors.forename: Cole
authors.initials: C
authors.lastname: Beavis
authors.forename: Abdel-Rahman
authors.initials: AR
authors.lastname: Aly
authors.forename: Dave
authors.initials: D
authors.lastname: Leswick
mesh_terms: D000328:Adult; D000868:Anterior Compartment Syndrome / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016022:Case-Control Studies; D002908:Chronic Disease; D015444:Exercise / Q000502:physiology; D005260:Female; D006801:Humans; D007866:Leg / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D010865:Pilot Projects; D011312:Pressure; D011446:Prospective Studies; D014463:Ultrasonography