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Exercise-Induced Acute Bilateral Upper-Arm Compartment Syndrome.

Brian C Traub¹, Mark K Lane², Jeff A Traub^1,3

¹Emory University School of Medicine, Atlanta, GA, USA.

Case Reports in Emergency Medicine

|November 1, 2017

Summary

A rare case of exercise-induced compartment syndrome in the upper arms occurred after intense pushups. Prompt fasciotomy and ICU care led to full recovery without lasting effects.

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Area of Science:

Sports Medicine
Orthopedics
Emergency Medicine

Background:

Compartment syndrome is a surgical emergency characterized by increased pressure within a fascial compartment.
Exercise-induced compartment syndrome is typically seen in the lower extremities, with upper extremity involvement being exceedingly rare.

Observation:

A patient presented with acute bilateral upper-arm pain and dark urine after performing over 100 pushups following a year of inactivity.
Physical examination revealed severe pain in the bilateral biceps and triceps muscles.

Findings:

The patient was diagnosed with acute exercise-induced bilateral upper-arm compartment syndrome.
Rhabdomyolysis with associated myoglobinuria necessitated intensive care unit (ICU) admission and treatment.
Decompressive fasciotomy was performed to relieve the compartment pressure.

Implications:

This case highlights that acute exercise-induced compartment syndrome, though rare, can affect the upper extremities.
Clinicians should consider this diagnosis in patients presenting with severe limb pain after unaccustomed strenuous exercise.
Early recognition and intervention are crucial for preventing long-term sequelae and ensuring functional recovery.