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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Gluteal compartment syndrome is a rare disorder that most often occurs in conjunction with prolonged immobility after a sedative overdose but also may result from direct trauma. Patients present with localized tenderness, induration, and pain with passive flexion of the gluteal muscles. Signs of sciatic nerve compression occur frequently, and rhabdomyolysis may be associated with the syndrome. If the diagnosis of gluteal compartment syndrome is suspected, intracompartmental pressures should be measured. If pressures are high or if sufficient clinical suspicion remains, the patient should undergo prompt fasciotomy.
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PMID:Gluteal compartment syndrome. 797 6

Compartment syndrome is a serious potential complication of trauma to the extremities. Fractures, crush injuries, burns, and arterial injuries, among others, can result in increased tissue pressure within closed osseofascial or compartmental spaces. Prolonged exposure to elevated pressure can result in nerve and muscle necrosis. Extreme pain unrelieved with analgesia, subjective complaint of pressure, pain with passive muscle stretching, paresis, paresthesia, and intact pulses, in the presence of a physically tight compartment, should alert the physician to the presence of a compartment syndrome. The diagnosis is a clinical one, but it may be aided by measurements of intracompartmental tissue pressures. Compartment syndrome is a surgical emergency requiring prompt treatment by fasciotomy. Time is a critical factor; the longer the duration of elevated tissue pressure, the greater the potential for disastrous sequelae. Emergency medicine providers must be cognizant of this clinical syndrome so that early emergent surgical consultation can be obtained to avoid complications.
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PMID:Compartment syndrome: a complication of acute extremity trauma. 798 93

The chronic anterior compartment syndrome of the forearm is a rare pathology (3 cases have been already published), and of new knowledge. Three new cases on 2 patients (one on both sides) are described here. The authors describe recent advances about physiopathology, exploration and surgical treatment. It is due to strenuous activity using flexor muscles of the forearm without any release period (here motor cyclist competition). The symptom was pain at the anterior forearm similar to cramp. The most important for diagnosis was to measure the pressure after activity. The threshold level read after activity was up to 30 mm of Hg, with a very slow coming back to normal value. The isotopic scanner with hydroxyl methylene di-phosphonate (HMDP), after activity, showed a delay of arrival of the tracer and a stasis. RMI seems to give abnormal modification of the signal. The only treatment was surgical and an open fasciotomy of superficial and deep fascia must be done, with opening of the muscle's perimysium. The patients became painfree and resumed their sport after surgical treatment.
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PMID:[Chronic stress-related compartment syndrome of the forearm]. 806 83

Chronic pancreatitis is characterized by persistent and severe pain, which can be relieved by decompression of the main pancreatic duct (MPD). Both ductal and interstitial pressures have been shown to be increased in chronic pancreatitis in patients. A study was carried out of pancreatic interstitial pressure and pancreatic blood flow in normal cats and those in which chronic obstructive pancreatitis had been induced 5 weeks earlier to determine the effect of decompression of the MPD. In the normal pancreas, median(interquartile range (i.q.r.)) basal interstitial pressure was 0.05(1.2) mmHg and median(i.q.r.) basal pancreatic blood flow 58.3(24.3) ml per min per 100 g. Secretory stimulation did not change the interstitial pressure significantly, but was associated with a 40 per cent increase in median(i.q.r.) blood flow to 81.8(45.8) ml per min per 100 g. In contrast, in chronic obstructive pancreatitis, the median(i.q.r.) basal interstitial pressure was 2.0(1.5) mmHg, which was significantly higher than in the normal gland, and median(i.q.r.) pancreatic blood flow was 38.3(9.8) ml per min per 100 g, significantly lower than in the normal pancreas. Furthermore, secretory stimulation was associated with a significant increase in median(i.q.r.) interstitial pressure to 3.3(1.6) mmHg and a simultaneous decrease in median(i.q.r.) blood flow to 31.5(13.7) ml per min per 100 g. After decompression of the MPD in cats with chronic obstructive pancreatitis, the median(i.q.r.) basal interstitial pressure was 2.0(1.4) mmHg and on secretory stimulation 1.8(1.5) mmHg. Decompression thus prevented the increase in interstitial pressure seen in the animals with obstruction. In contrast, ductal decompression improved the median(i.q.r.) basal pancreatic blood flow to 45.9(38.4) ml per min per 100 g and, furthermore, this increased significantly on secretory stimulation to a median(i.q.r.) of 81.4(47.8) ml per min per 100 g. Decompression thus restored the normal pattern of secretory hyperaemia. Within the confines of this model, these observations demonstrate that chronic obstructive pancreatitis exhibits a compartment syndrome that is relieved by duct drainage.
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PMID:Compartment syndrome in experimental chronic obstructive pancreatitis: effect of decompressing the main pancreatic duct. 782 Apr 97

Compartment syndrome in the hand and forearm is a serious and debilitating complication of crush injury. Pain with passive motion is the most reliable physical finding; however, compartment pressure measurement is the only truly reliable method of diagnosis. Immediate and adequate decompression will prevent the development of Volkmann's ischemic contracture and its associated severe loss of function in the affected extremity.
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PMID:Compartment syndrome of the forearm and hand. 818 74

The development of compartment syndrome is a well-recognized clinical entity. The diagnosis and management of compartment syndrome in the adult population is well established. Because of the difficulty with cooperation in physical examination of children with pain, the early recognition of compartment syndrome in this group of patients can be more challenging. Furthermore, the potential inability to make a prompt and accurate diagnosis can lead to significant extremity morbidity and possibly mortality.
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PMID:Compartment syndrome in children. 819 62

We retrospectively reviewed the cases of three patients with injuries similar to the mechanism of an ankle sprain which resulted in compartment syndrome of the lower extremity. All three patients presented with sharp, proximal, anterolateral pain in the leg after an indirect, twisting injury. None of the injuries involved direct contact. Two of the three athletes initially presented to local hospitals, where the injury was misdiagnosed as an ankle sprain. The mechanism appears to be a muscle strain or tear with resultant hemorrhage in the compartment. All three patients returned to high-level athletics after prolonged recovery periods.
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PMID:Acute compartment syndrome of the lower extremity secondary to noncontact injury. 831 90

Peripheral nerve lesions are uncommon but serious injuries which may delay or preclude an athlete's safe return to sports. Early, accurate anatomical diagnosis is essential. Nerve lesions may be due to acute injury (e.g. from a direct blow) or chronic injury secondary to repetitive microtrauma (entrapment). Accurate diagnosis is based upon physical examination and a knowledge of the relative anatomy. Palpation, neurological testing and provocative manoeuvres are mainstays of physical diagnosis. Diagnostic suspicion can be confirmed by electrophysiological testing, including electromyography and nerve conduction studies. Proper equipment, technique and conditioning are the keys to prevention. Rest, anti-inflammatories, physical therapy and appropriate splinting are the mainstays of treatment. In the shoulder, spinal accessory nerve injury is caused by a blow to the neck and results in trapezius paralysis with sparing of the sternocleidomastoid muscle. Scapular winging results from paralysis of the serratus anterior because of long thoracic nerve palsy. A lesion of the suprascapular nerve may mimic a rotator cuff tear with pain a weakness of the rotator cuff. Axillary nerve injury often follows anterior shoulder dislocation. In the elbow region, musculocutaneous nerve palsy is seen in weightlifters with weakness of the elbow flexors and dysesthesias of the lateral forearm. Pronator syndrome is a median nerve lesion occurring in the proximal forearm which is diagnosed by several provocative manoeuvres. Posterior interosseous nerve entrapment is common among tennis players and occurs at the Arcade of Froshe--it results in weakness of the wrist and metacarpophalangeal extensors. Ulnar neuritis at the elbow is common amongst baseball pitchers. Carpal tunnel syndrome is a common neuropathy seen in sport and is caused by median nerve compression in the carpal tunnel. Paralysis of the ulnar nerve at the wrist is seen among bicyclists resulting in weakness of grip and numbness of the ulnar 1.5 digits. Thigh injuries include lateral femoral cutaneous nerve palsy resulting in loss of sensation over the anterior thigh without power deficit. Femoral nerve injury occurs secondary to an iliopsoas haematoma from high energy sports. A lesion of the sciatic nerve may indicate a concomitant dislocated hip. Common peroneal nerve injury may be due to a direct blow or a traction injury and results in a foot drop and numbness of the dorsum of the foot. Deep and superficial peroneal nerve palsies could be secondary to an exertional compartment syndrome. Tarsal tunnel syndrome is a compressive lesion of the posterior tibial nerve caused by repetitive dorsiflexion of the ankle--it is common among runners and mountain climbers.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Peripheral nerve injuries in athletes. Treatment and prevention. 837 68

Anterior compartment pressure was measured in 10 competitive runners and in 10 competitive cyclists who were asymptomatic for compartment syndrome. Pressures were measured at rest, after exercise at 80% VO2max, after maximal exercise, and 15 minutes after both exercise bouts. No difference in compartment pressure was found after exercise at 80% VO2max in runners and cyclists. Total creatinine phosphokinase enzyme levels measured before and after exercise at 80% VO2max showed a 10-fold increase in runners as compared to cyclists. Anterior compartment pressure measured after maximal exercise was significantly greater in runners as compared to cyclists. Compartment pressure showed no increase from resting values during cycling at 80% VO2max or maximal exercise. These findings suggest that patients with chronic anterior compartment syndrome may be able to cycle without elevation of compartment pressure and concomitant pain as an alternative exercise to maintain a continued degree of fitness and training. Compartment pressures should be measured during cycling in patients with chronic compartment syndrome to determine its efficacy as a method for maintenance of cardiorespiratory fitness.
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PMID:A comparison of anterior compartment pressures in competitive runners and cyclists. 842 66

A case of an acute compartment syndrome of the triceps muscle complicating a surgical neck fracture of the humerus is presented. Diagnosis was suspected because of pain with passive elbow flexion and pain out of proportion to the clinical situation. Diagnosis was confirmed with intracompartmental pressure measurements. An emergency fasciotomy was performed. The patient had an excellent result.
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PMID:Acute compartment syndrome of the triceps. A case report. 845 31


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