Acute compartment syndrome caused by uncontrolled hypothyroidism

Area of Science:

• Endocrinology
• Trauma Surgery
• Emergency Medicine

Background:

• Acute compartment syndrome (ACS) is a surgical emergency caused by elevated tissue pressure impairing perfusion.
• Typical causes include crush injuries, burns, and trauma, but non-traumatic etiologies are less common.
• Hypothyroidism is a systemic condition affecting metabolism and potentially tissue function.

Observation:

• A 42-year-old female with hypothyroidism presented with acute right lower extremity pain and swelling.
• Physical examination and elevated compartment pressures confirmed ACS.
• No obvious traumatic cause was identified; laboratory tests revealed uncontrolled hypothyroidism.

Findings:

• This case highlights a rare association between ACS and uncontrolled hypothyroidism.
• The patient underwent emergent fasciotomy and thyroid hormone replacement therapy.
• Uncontrolled hypothyroidism was identified as a potential contributing factor.

Implications:

• This case underscores the importance of considering less common causes for non-traumatic ACS.
• Evaluating for underlying endocrine disorders, such as hypothyroidism, is crucial in atypical presentations.
• Understanding the pathogenesis of ACS in hypothyroid patients may improve diagnostic and therapeutic strategies.