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Acute Limb Ischemia and Compartment Syndrome

Mary Cheffers1, Nikolas Ujueta1

  • 1Department of Emergency Medicine, USC/Los Angeles General Medical Center, 1200 N State Street, Suite 1060, Los Angeles, CA 90033, USA.

Emergency Medicine Clinics of North America
|March 27, 2026
PubMed

Insights

Timely diagnosis of acute limb ischemia (ALI) and compartment syndrome (CS) is crucial. Missed diagnoses stem from overlooking pulse exams, subtle early signs of ALI, and atypical presentations of CS in at-risk patients.

Area of Science:

  • Vascular Surgery
  • Emergency Medicine
  • Orthopedic Surgery

Background:

  • Acute limb ischemia (ALI) and compartment syndrome (CS) are critical conditions with severe consequences if diagnosis is delayed.
  • Subtle presentations and provider oversight contribute to missed diagnoses of ALI and CS.

Purpose of the Study:

  • To highlight the importance of timely diagnosis for ALI and CS.
  • To identify common pitfalls in the diagnosis of ALI and CS.

Main Methods:

  • Review of clinical presentations and diagnostic challenges associated with ALI and CS.
  • Emphasis on physical examination techniques and awareness of atypical scenarios.

Main Results:

  • Failure to perform pulse examinations can lead to missed ALI diagnoses.
  • Lack of awareness regarding atypical presentations of CS contributes to diagnostic delays.
  • Early ALI signs can be subtle and easily overlooked.

Conclusions:

  • Vigilance in pulse examination is essential for ALI diagnosis.
  • Consideration of CS in at-risk populations and recognition of atypical signs are critical.
  • Prompt diagnosis of ALI and CS is paramount to prevent limb-threatening complications.

Keywords:
Acute limb ischemiaCompartment syndromePain out of proportionPhysical examination

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