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CC BY-NC-ND 4.0 · Int J Sports Med 2023; 44(01): 20-28
DOI: 10.1055/a-1866-5957
Review

Systematic Review of Innovative Diagnostic Tests for Chronic Exertional Compartment Syndrome

Ewan D. Ritchie
1   Department of Surgery, Alrijne Hospital Location Leiderdorp, Leiderdorp, Netherlands
,
Sanne Vogels 
1   Department of Surgery, Alrijne Hospital Location Leiderdorp, Leiderdorp, Netherlands
2   Department of Trauma Surgery, Erasmus Medical Center, Rotterdam, Netherlands
,
Thijs T. C. F. van Dongen
1   Department of Surgery, Alrijne Hospital Location Leiderdorp, Leiderdorp, Netherlands
3   Defence Healthcare Organization, Ministry of Defense, Utrecht, Netherlands
,
Boudewijn L. S. Borger van der Burg
1   Department of Surgery, Alrijne Hospital Location Leiderdorp, Leiderdorp, Netherlands
,
Marc R. M. Scheltinga
4   Department of Surgery, Máxima Medical Centre, Veldhoven, Netherlands
,
Wes O. Zimmermann
5   Department of Sports Medicine, Royal Netherlands Army, Utrecht, Netherlands
6   Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, United States
,
Rigo Hoencamp
1   Department of Surgery, Alrijne Hospital Location Leiderdorp, Leiderdorp, Netherlands
3   Defence Healthcare Organization, Ministry of Defense, Utrecht, Netherlands
7   Department of Surgery, Leiden University Medical Center, Leiden, Netherlands
8   Trauma Research Unit, Department of Trauma Surgery, Erasmus Medical Center, Rotterdam, Netherlands
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Abstract

The diagnosis chronic exertional compartment syndrome is traditionally linked to elevated intracompartmental pressures, although uncertainty regarding this diagnostic instrument is increasing. The aim of current review was to evaluate literature for alternative diagnostic tests. A search in line with PRISMA criteria was conducted. Studies evaluating diagnostic tests for chronic exertional compartment syndrome other than intracompartmental pressure measurements were included. Bias and quality of studies were evaluated using the Oxford Levels of Evidence and the QUADAS-2 instrument. A total of 28 studies met study criteria (MRI n=8, SPECT n=6, NIRS n=4, MRI and NIRS together n=1, miscellaneous modalities n=9). Promising results were reported for MRI (n=4), NIRS (n=4) and SPECT (n=3). These imaging techniques rely on detecting changes of signal intensity in manually selected regions of interest in the muscle compartments of the leg. Yet, diagnostic tools and protocols were diverse. Moreover, five studies explored alternative modalities serving as an adjunct, rather than replacing pressure measurements. Future research is warranted as clinical and methodological heterogeneity were present and high quality validation studies were absent. Further optimization of specific key criteria based on a patient’s history, physical examination and symptom provocation may potentially render intracompartmental pressure measurement redundant.

Key words

chronic exertional compartment syndrome - lower extremity - intracompartmental pressure measurement - alternative - diagnostic tests

Supplementary Material



Publikationsverlauf

Eingereicht: 06. Februar 2022

Angenommen: 30. Mai 2022

Accepted Manuscript online:
01. Juni 2022

Artikel online veröffentlicht:
22. Juli 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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