Compartment Syndrome

Compartment syndrome is a medical term which refers to the compression of nerves, blood vessels and muscle inside a closed space (compartment) within the body. This leads to tissue death due to lack of oxygenation as the blood vessels are compressed by the raised pressure within the compartment. Compartment syndrome most commonly involves the forearm and lower leg. It can be divided into acute, subacute or chronic compartment syndrome.

Compartment syndrome Symptoms and signs

There are classically 5 “Ps” associated with compartment syndrome — pain out of proportion to what is expected, paresthesia, pallor, paralysis, pulselessness; sometimes a 6th P, for polar/poikilothermia (failure to thermoregulate) is added. Of these, only the first two are reliable in the diagnosis of compartment syndrome. Paresthesia, however, is a late symptom.

• Pain is often reported early and almost universally. The description is usually of severe, deep, constant, and poorly localized pain, sometimes described as out of proportion with the injury. The pain is aggravated by stretching the muscle group within the compartment and is not relieved by analgesia up to and including morphine.
• Paresthesia (altered sensation e.g. “pins & needles”) in the cutaneous nerves of the affected compartment is another typical sign.
• Paralysis of the limb is usually a late finding. The compartment may also feel very tense and firm (pressure). Some find that their feet and even legs fall asleep. This is because compartment syndrome prevents adequate blood flow to the rest of the leg.
• Note that a lack of pulse rarely occurs in patients, as pressures that cause compartment syndrome are often well below arterial pressures and pulse is only affected if the relevant artery is contained within the affected compartment.
• Tense and swollen shiny skin, sometimes with obvious bruising of the skin.
• Congestion of the digits with prolonged capillary refill time.

Read more detail about Compartment Syndrome at Wikipedia

What is Rhabdomyolysis?

Rhabdomyolysis (RAB-DOE-MY-O-LIE-SIS) is the rapid destruction of skeletal muscle resulting in leakage into the urine of the muscle protein myoglobin.

There are three different types of muscle in the human body:

1. smooth muscle,
2. skeletal muscle, and
3. heart muscle.

The skeletal muscle is the muscle of movement of the body (moving the skeleton at the joints). Skeletal muscle is affected by rhabdomyolysis.

Myoglobin is a protein component of the muscle cells that is released into the blood when the skeletal muscle is destroyed in rhabdomyolysis. Creatine kinase is an enzyme (a protein that facilitates chemical reactions in the body) also in the muscle cells. The level of each of these proteins can be measured in blood to monitor the degree of muscle injury from rhabdomyolysis. Myoglobin can also be measured in samples of urine.

Rhabdomyolysis Symptoms

Rhabdomyolysis may not cause any symptoms at all. Muscle aches and pain (myalgia), stiffness, and muscle weakness can occur with rhabdomyolysis, and is especially common with severe muscle damage. Rhabdomyolysis may cause a darkening of the urine color. Myoglobin is released from the muscles when they break down and is excreted into the urine. This can cause a red or cola color of the urine.

Read more detail about rhabdomyolysis at: