title: Acute compartment syndrome caused by uncontrolled hypothyroidism.
abstract: Acute compartment syndrome is increased tissue pressure exceeding perfusion pressure in a closed compartment resulting in nerve and muscle ischemia. Common precipitating causes are crush injuries, burns, substance abuse, osseous or vascular limb trauma. This is a case of 42year old female with history of hypothyroidism who presented to emergency room with acute onset of severe pain and swelling in right lower extremity. Physical examination was concerning for acute compartment syndrome of right leg which was confirmed by demonstration of elevated compartmental pressures. No precipitating causes were readily identified. Further laboratory testing revealed uncontrolled hypothyroidism. Management included emergent fasciotomy and initiating thyroid hormone replacement. This case represents a rare association between acute compartment syndrome and uncontrolled hypothyroidism. We also discuss the pathogenesis of compartment syndrome in hypothyroid patients and emphasize the importance of evaluating for less common causes, particularly in setting of non-traumatic compartment syndrome.
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism, Cooper University Hospital, United States. Electronic address: anarmodi86@gmail.com.
authors.forename: Anar
authors.initials: A
authors.lastname: Modi
authors.affiliation: Emergency Medicine, Cooper University Hospital, United States.
authors.forename: Hari
authors.initials: H
authors.lastname: Amin
authors.affiliation: Emergency Medicine, Cooper University Hospital, United States.
authors.forename: Matthew
authors.initials: M
authors.lastname: Salzman
authors.affiliation: Endocrinology, Diabetes and Metabolism fellowship, Cooper University Hospital, United States.
authors.forename: Farah
authors.initials: F
authors.lastname: Morgan
mesh_terms: D000208:Acute Disease; D000328:Adult; D003161:Compartment Syndromes / Q000209:etiology*; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000150:complications*; D035002:Lower Extremity / Q000503:physiopathology*; D010146:Pain; D010808:Physical Examination