[Differential diagnosis of the anterior tibial syndrome]

The tibialis anterior syndrome, which is the most frequent so-called compartment syndrome of the lower extremity, is described by means of the pathophysiological processes generally applicable to the compartment syndrome. Both the clinical signs and treatment as well as the diagnosis are given in this article. To extend the differential diagnosis the authors present a woman patient referred to hospital with the pattern of a tibialis anterior syndrome as shown by anamnesis and clinical signs. However, surgery did not reveal any traumatic action as the cause of the tibialis anterior syndrome; instead, the real cause was large lipoma which in our opinion gradually resulted in a pressure increase in the anterior tibial muscle area. The accident which had been considered responsible had in our opinion merely tended to aggravate an already existing condition which would surely have resulted eventually in an intrafascial pressure increase and in the development of a tibialis anterior syndrome pattern even without any trauma. Hence, the pattern of a tibialis anterior syndrome had been caused in this particular case by a space-occupying growth in the area of the anterior tibial muscle, i.e. by a lipoma, Correspondingly, one should always consider when performing differential diagnosis of the tibialis anterior syndrome whether the underlying cause may be a space-occupying growth, such as a tumour.