Simvastatin Induced Rhabdomyolysis of Anterior Compartment of Leg Resulting in Foot Drop

A 65-year-old physically active man presented with sudden onset leg pain and inability to dorsiflex his foot following a trivial fall. There was no tenseness in the anterior compartment and compartment pressure was normal. Three days later he developed erythema with pitting oedema of the leg. Serum creatine kinase was 14000 U/l initially which gradually decreased. Subsequent Doppler scans and MRI showed evidence of myositis involving the entire anterior compartment. The patient reported a history of simvastatin use for the past year. A nerve conduction study confirmed common peroneal nerve palsy. This case report highlights a rare complication of simvastatin use presenting with foot drop resulting from muscle damage and nerve palsy.