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Persisting shin tenderness and erythema
JAAPA, 10/23/09

Alden–St. Pierre DM – A 23–year–old man presented to the emergency department (ED) complaining of pain and redness on the anterior portion of his right shin. He reported that the pain had actually started about 7 days ago and was initially in both shins...Acute compartment syndrome (CS) may be seen in patients with trauma, thermal injuries, frostbite, or with circumferential constrictive dressings/casts. Patients typically present with severe pain, often out of proportion to examination findings and exacerbated by passive stretching of the affected muscles. Sensory deficits can appear before weakness or paralysis, and absent pulses and pallor are usually late findings. A prompt diagnosis is important because early decompression has a greater than 90% success rate for full resolution of symptoms. This patient had an emergent decompression fasciotomy and was admitted for observation.

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