Exogenous Peptide Injection Causing Medical Thigh Compartment Syndrome

Area of Science:

• Emergency Medicine
• Toxicology
• Musculoskeletal Disorders

Background:

• The use of peptide injections for weight loss and muscle gain is increasing.
• Acute compartment syndrome (ACS) is a surgical emergency caused by increased intracompartmental pressure, leading to ischemia.
• This case highlights a novel cause of ACS from exogenous peptide injection.

Observation:

• A 43-year-old male presented with severe thigh pain 3 days after self-injecting a "peptide cocktail."
• Physical exam revealed edema, muscle spasm, tenderness, and numbness in the thigh and knee.
• Point-of-care ultrasound confirmed intramuscular edema and fluid, consistent with ACS.

Findings:

• The patient was diagnosed with acute compartment syndrome of the thigh secondary to peptide injection.
• A large hematoma was identified posterior to the adductor magnus muscle.
• Surgical fasciotomy and hematoma evacuation were required.

Implications:

• This case is the first documented instance of peptide injection causing compartment syndrome.
• Emergency physicians must consider peptide injections in patients presenting with atraumatic limb pain and swelling.
• Awareness of potential complications from popular supplements is crucial for patient safety.