![]() ![]() They have been described in normal individuals and in a professional motorcyclist, but this is the first report of a CECS as a result of weight‐training. The peaks occur during forearm flexion (ff).ĬECS of the forearm is extremely rare and only a few cases have been described in the literature. Intracompartmental pressures in the right and left forearms. Our patient was treated with a bilateral fasciotomy and made an uneventful recovery. CECS can be treated conservatively in the first instance but most patients only recover with surgical intervention. These results clearly showed that the exercise‐induced ICP in this patient was sufficient to impede muscle perfusion, thereby precipitating his symptoms and confirming the diagnosis of CECS. The resting ICPs were 25–26 mmHg and reached 35 mmHg during exercise (Fig. 1 ). The pressure measurements were made at rest and during forearm flexion exercises which reproduced the pain. In the light of the history and these normal results, the intracompartmental pressure (ICP) in both deep flexor compartments was measured using a standard ICP measuring system. Nerve conduction studies in the right and left ulnar and median nerves were all within normal limits. Initial investigations showed normal plain X‐rays of both forearms and a normal radioisotope bone scan of the upper limbs, making stress fractures unlikely. No joint abnormalities were found and Tinel's and Phalen's tests for carpal tunnel syndrome were negative. The peripheral arterial pulses were present and normal. ![]() Neurological examination of the upper limbs was normal. Physical examination revealed a muscular individual with no wasting or asymmetry of the upper limbs. He was on no medications at the time of presentation and in particular there was no history of the use of illicit performance‐enhancing drugs. There were no other musculoskeletal symptoms and he was otherwise in good health. There were no forearm symptoms when he was not weight‐training. The pain slowly resolved on cessation of the exercise but recurred each time this exercise was performed. The pain was precipitated by resistance exercises which required flexion at the elbow and the wrist (‘biceps arm curls’). A 23‐yr‐old man was referred with a 2‐yr history of pain in the medial side of both forearms which occurred during weight training. Here we present the case of young man presenting to a rheumatology clinic with bilateral arm pain, which was subsequently diagnosed as a CECS. CECS is extremely rare in the forearm and, as illustrated by the case described here, can present a difficult diagnostic problem. Chronic exertional compartment syndromes (CECS) are much less common and usually occur in the lower limb compartments. The most common sites involved are the thigh, calf and forearm. CS usually presents acutely, most commonly as a result of fractures, muscle rupture or intracompartmental vascular injury, and generally requires immediate surgical treatment. S ir, Compartment syndrome (CS) occurs when the interstitial pressure in a closed fascial compartment increases to such a degree that local blood flow is compromised, resulting in tissue ischaemia. ![]()
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