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Updated: Feb 16, 2026
04:34
A Novel Non-invasive Method for the Detection of Elevated Intra-compartmental Pressures of the Leg
Published on: May 31, 2019
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Posterior Tibial Arterial System Deficiency Mimicking Chronic Exertional Compartment Syndrome: A Case Report
Kyle P Lavery1, Bertrand W Parcells, Timothy Hosea
1Department of Orthopaedic Surgery, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey.
JBJS Case Connector
|December 19, 2017
Summary
A young athlete experienced persistent calf pain, initially diagnosed as chronic exertional compartment syndrome. However, recurrent symptoms revealed a previously undetected vascular issue, highlighting the importance of considering arterial problems in exertional leg pain.
Area of Science:
- Sports Medicine
- Vascular Surgery
- Athletic Performance
Background:
- Chronic exertional compartment syndrome (CECS) is a common cause of leg pain in athletes.
- Diagnosis typically involves clinical presentation and compartment pressure measurements.
- Surgical intervention, such as fasciotomy, is a standard treatment for CECS.
Observation:
- A 15-year-old female basketball player with a 3-month history of bilateral exertional calf pain.
- Initial diagnosis of CECS was made based on history and compartment pressures.
- Bilateral fasciotomies were performed, but symptoms recurred postoperatively.
Findings:
- Advanced imaging revealed a deficient posterior tibial arterial system bilaterally.
- The recurrent symptoms were attributed to an underlying vascular anomaly.
- This case underscores a potential limitation in diagnosing CECS without considering vascular causes.
Implications:
- Vascular etiologies should be carefully considered in athletes with exertional leg pain, especially when symptoms persist or recur after standard treatment.
- Deficiencies in the posterior tibial arterial system can mimic or coexist with CECS.
- Comprehensive diagnostic workups for exertional leg pain in athletes may require vascular imaging.
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