Compartment Syndrome

Compartment syndrome often involves the calf following blunt trauma or fracture [21,22]. It may also result from muscle strain injury and associated swelling and hematoma (Fig. 29). Compartment syndrome without muscle injury has been described in the anterior compartment of the lower leg in soccer players [127]. Increased pressure within fascial compartments leads to capillary circulatory compromise with ischemia to the musculature and nerves, and progress to tissue necrosis if left untreated. While typically a clinical diagnosis confirmed with pressure measurements, MR may be used to evaluate the extent of involvement but should not delay intervention in emergency cases. Findings in the acute setting include increased T2 signal with muscle enlargement, edema, or both [10].

Compartment syndrome can also be chronic, as a result of neoplasm or associated with exercise (Fig. 30). MRI before and after exercise may demonstrate increased T2 signal in the compartment of concern [128-131]. Although a recent prospective study comparing the invasive gold standard of direct

Ganglion Proximal Tibiofibular Joint

Fig. 28. Proximal tibiofibular joint ganglion (white arroW) with mass effect on the anterior branch of peroneal nerve resulting in muscle denervation and edema (black arrow) (A). Coronal T1 image showing diffuse fatty infiltration of medial gastrocnemius muscle related to prior trauma and loss of normal muscle architecture (arrow) (B).

Fig. 28. Proximal tibiofibular joint ganglion (white arroW) with mass effect on the anterior branch of peroneal nerve resulting in muscle denervation and edema (black arrow) (A). Coronal T1 image showing diffuse fatty infiltration of medial gastrocnemius muscle related to prior trauma and loss of normal muscle architecture (arrow) (B).

pressure measurement with near infrared spectroscopy (NIRS, a noninvasive method detecting hemoglobin saturation), and MRI discovered that NRIS was equivalent to direct pressure measurements and superior to MRI [132].

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