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Compartment Pressure Testing

What is Compartment Pressure Testing?

Compartment pressure testing is the gold standard test to confirm the diagnosis of chronic exertional compartment syndrome, a life-threatening limb condition commonly seen in athletes and runners.

How is Chronic Exertional Compartment Syndrome Caused?

Your muscles naturally expand when you exercise. However, if you have chronic exertional compartment syndrome, the tissue that covers the muscle does not expand along with the muscle resulting in increased pressure in a particular area (compartment) of the affected limb causing symptoms of chronic exertional compartment syndrome.

What are the Common Symptoms that may necessitate Compartment Pressure Testing?

Some of the common symptoms associated with chronic exertional compartment syndrome include:

  • Persistent pain coupled with a burning sensation in the affected muscle
  • Numbness or tingling sensation in the affected muscle
  • Swelling or bulging in the affected muscle
  • Weakness of the affected muscle with reports of foot drop in severe cases

How is Chronic Exertional Compartment Syndrome Diagnosed?

To diagnose chronic exertional compartment syndrome, your doctor may prefer to examine you after rigorous exercise so that muscle bulge, tension or tenderness may be noted in the affected area.

Imaging studies would typically include:

  • MRI scans to evaluate muscle structure in the compartments and analyze the fluid volumes of the compartments during exercise.
  • Near-infrared spectroscopy (NIRS) to measure the amount of oxygen present in the blood of the affected tissue.

If results from imaging studies are unclear, then your doctor may suggest compartment pressure testing.

How is Compartment Pressure Testing Done?

This procedure is done under local anesthesia where a needle will be placed in the compartment to be examined of the lower leg. You will be then asked to exercise on a treadmill to measure the pressure in the compartment as you are exercising. You may observe some bleeding at the needle insertion site. The procedure can be mildly painful, but the pain normally wears off quickly after the completion of the test.

What are the Benefits of Compartment Pressure Testing?

This testing helps in distinguishing chronic exertional compartment syndrome from other contributive reasons for ongoing pain in the arms or legs. The testing is relatively straightforward and short, and the results are available immediately.

What are the Risks Associated with Compartment Pressure Testing?

Even though the test is considered a very safe procedure, some risks associated with the procedure include:

  • Bruising at the testing site
  • Risk of infection at the site of needle insertion
  • Swelling, pain, or temperature in the days after the procedure
  • Rarely, a chance of acute compartment syndrome if damage of blood vessels in your legs is noted during the procedure
  • American Academy of Orthopaedic Surgeons
  • American Medical Association
  • State Orthopaedic Society UTAH
  • Medical College of Wisconsin