Role of ultrasound as a non-invasive method of diagnosis of chronic exertional compartment syndrome

Chronic exertional compartment syndrome (CECS) is a well-recognised condition, which can result in significant morbidity and limitation of activity in athletes and non-athletes alike. At present invasive intramuscular pressure (IMP) measurements are still considered the gold standard for diagnosing CECS. The non-invasive nature of ultrasound makes it an attractive alternative to direct IMP measurement. This retrospective study is a literature and case review of 34 subjects with exercise-induced leg pain who underwent ultrasound compartment measurement for CECS. Eighteen (group P) of 34 were found to be positive. Fifteen of group P demonstrated calf increases of >15 mm and an additional three with increases of <15 mm failed to return to the resting state at 10 mins after exercise. Sixteen subjects demonstrated a normal ultrasound after exercise. At follow-up (1–2 years) a telephonic interview of 25 participants showed that 15 of the 18 with a positive confirmation of CECS had responded well to surgical decompression and 10 of the 16 negative cases had responded well to conservative treatment. This study suggests that ultrasound may be a useful tool for the assessment of CECS.