[Anterior compartment syndrome of the forearm caused by exercise: unusual cause of recurrent episodes of acute effort rhabdomyolysis]

Effort Thrombosis Presenting as Unilateral "Pumped" Arm in a Climber

Upper extremity injuries are common among the growing population of climbers. Although conditions affecting musculoskeletal structures are the most common causes of symptoms, a comprehensive differential diagnosis is necessary to avoid the misdiagnosis of high-morbidity conditions in this patient population. We present a case of a climber with acute edema, erythema, and pain of the entire right upper extremity. After confirmation of an upper extremity deep vein thrombosis by ultrasound, and in the absence of secondary causes for his thrombotic process, he was diagnosed with effort thrombosis. The patient was treated acutely with anticoagulation, catheter thrombectomy, direct thrombolysis, and balloon angioplasty followed by surgical decompression of the subclavian vein. Owing to the importance of early diagnosis and initiation of treatment, it is critical to keep disorders affecting the upper thoracic vascular structures in consideration.

Motorcycle racer with unilateral forearm flexor and extensor chronic exertional compartment syndrome

We discuss a case of a 26-year-old man, a motorcycle racer, who presented with progressive pain, weakness and swelling of his right forearm and loss of power in his index finger, experienced during motor racing. Chronic exertional compartment syndrome (CECS) of both flexor and extensor compartments of his forearm was diagnosed by dynamic intracompartmental muscle pressure measurements. After fasciotomies, all symptoms were resolved and the patient was able to improve on his preinjury racing skills, without any limitations. A literature review and a surgical 'how-to' for correct release of the extensor and deep flexor compartments of the forearm are provided.

Isolated exercise-induced rhabdomyolysis of brachialis and brachioradialis muscles: an atypical clinical case

OBJECTIVE AND PATIENT: To report an atypical case of exercise-induced bilateral brachialis and brachioradialis rhabdomyolysis in a 25-year-old woman.

DISCUSSION AND CONCLUSION

Persistent focal muscle pain, atypical by its duration and intensity, even after moderate exercise, should prompt the search for rhabdomyolysis and discuss the possibility of acute compartment syndrome. MRI images can validate the muscle edema. Progressive and adapted training as well as respecting individual limits are necessary measures to prevent rhabdomyolysis.

Acute forearm compressive myopathy syndrome secondary to upper limb entrapment: an unusual cause of renal failure

Compressive myopathy syndrome (SCM) is a syndrome characterized by the lesion of skeletal muscle resulting in subsequent release of intracellular contents (myoglobin, creatine phosphokinase, potassium, etc.) into the circulatory system, which can cause potentially lethal complications. There are numerous causes that can lead to SCM resulting to acute rhabdomyolysis, and many patients present with multiple causes. The most common potentially lethal complication is acute renal failure. The occurrence of acute rhabdomyolysis should be considered as a possibility in any patient who can remain stationary for long periods, or is in a coma, or is intoxicated in any form. We report the rare case of a 26-year-old patient who developed SCM caused by ischemia reperfusion, with subsequent acute rhabdomyolysis and acute renal failure after prolonged compression of the right upper extremity.

Compartment syndrome after hypocalcemic tetany: a case report

Compartment syndrome results from pathologically elevated muscle tissue pressure within a closed space. It is almost always related to either trauma or reperfusion after loss of arterial inflow from occlusion of a major blood vessel. We present an unusual case of nontraumatic and nonvascular compartment syndrome after hypocalcemia-induced sustained tetany in a 2-year-10-month-old male child after a neuroblastoma tumor resection. This particular cause of compartment syndrome has been described only once before in an adult patient.