[Microcirculation of the skeletal muscle]

There are certain claudications deriving from over-intense or over-prolonged muscular activity, caused by excessive tissular pressure in the fascial cavity of the leg, anterior rather than lateral. This usually occurs in young subjects who are athletic, sportive, or soldiers. The clinical symptom is a sudden jab, like a whip-crack, both painful and paretic. The direct measurement of tissular pressure, using the needle method, confirms the excess of pressure already high when the patient is resting; it rises manifestly with muscular effort and slowly falls again after it. The pressure-gradient calls for fasciotomy in hyperalgetic cases from a certain tissular pressure-gradient onwards. Phlebography has shown the venous collapse and clinical attention is often in these cases to the presence of "muscular hernia" in the leg. Clinical data are self-explanatory and Reneman recently recalled this with a case of capillaro-venular stasis, followed by an excess of permeability and the formation of interstitial oedema which has a restraining effect. Structures and functions of the microcirculation of the skeletal muscle enable us to understand the phenomena.