Īcute trauma is the most frequent cause of acute compartment syndrome. Compartment syndrome occurs when the interstitial pressure rises above the diastolic blood pressure, and as a result capillary perfusion is compromised. Rapid volume increase in a compartment inevitably results in increased pressure in this compartment. The lower leg consists of four compartments: an anterior (extensor), a lateral (peroneal), a superficial posterior, and a deep posterior (flexor) muscle compartment, each of them enclosed by a firm fascia and separated by either the interosseous membrane or an intermuscular septum. However, swelling and increased echogenicity of the peroneus longus and brevis muscles were apparent (Figure 1). On imaging, the nerve demonstrated a normal caliber and echotexture, without extrinsic compression by a discrete mass or fluid collection. He then developed a drop foot, and a second ultrasound exam was ordered to evaluate the common peroneal nerve. However, the patient’s overall temperature was normal, and he showed no signs of systemic illness. Over the next few days, all clinical findings and the pain increased, and the lateral lower leg became swollen.

In combination with redness and elevated temperature of the overlying skin, the imaging findings were interpreted as infectious cellulitis. No trauma occurred during the game.Īn ultrasound exam of the lower leg was ordered, which showed extensive subcutaneous edema. The pain started shortly after playing a soccer game in competition. A 21-year old male patient presented to the emergency department with pain in the lateral aspect of his left lower leg.

Compartments of the lower leg