A rare case of ischaemic stroke following cervical spine manipulation in an adolescent girl

Stroke in children is associated with a multitude of risk factors compared to risk factors of adult stroke such as hypertension, diabetes or atherosclerosis. A 15-year adolescent girl presented with acute onset weakness involving right upper and lower limb. She complained of neck pain and fever 2 days before the onset of hemiparesis for which her parents took her to traditional healer who performed neck manipulation after which she developed vomiting, tingling numbness and weakness of right upper and lower limb. There was no history of preceding headache, ear discharge or any other contributory history. Clinical examination revealed Glasgow Come Scale 12/15, power of grade 2/5 in right upper limb and 3/5 in right lower limb, exaggerated deep reflexes, extensor plantar reflex, right sided ptosis and right sided upper motor neuron facial palsy. CT scan brain showed right cerebellar and occipital infarct with posterior inferior cerebellar artery territory involvement. MRI Brain and MR Angiogram showed wedge shaped infarct involving right posterior inferior cerebellum, inferior vermis, ventral aspect of superior medulla, paracentral pons, right cerebral peduncle, tectum of both halves of midbrain with no internal hemorrhage and no vessel abnormality and right vertebral artery was not visualized. Her coagulation profile and cardiac work up were normal. She was treated with antiplatelet drugs, anticoagulants and physiotherapy following which the child gradually improved over a period of one month. In this case, with a positive history of neck manipulation authors can conclude that the etiology of young stroke wasinduced byneck manipulation. This case has been reported to increase awareness about the ill effects of neck manipulation and counsel parents against performing such procedures for children. Early recognition of pediatric stroke is critical for immediate diagnosis, imaging and treatment with better outcomes.

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Thrombosis of popliteal artery aneurysm with cutaneous microembolism of toes

International Surgery Journal ◽

10.18203/2349-2902.isj20195147 ◽

2019 ◽

Vol 6 (11) ◽

pp. 4167

Author(s):

Harilal Nambiar ◽

Robin George Manappallil ◽

Pramod Valayanad ◽

Anoop Madayambath

Keyword(s):

Popliteal Artery ◽

Lower Limb ◽

Artery Aneurysm ◽

Acute Onset ◽

Limb Pain ◽

Popliteal Artery Aneurysm ◽

Popliteal Entrapment ◽

Lower Limb Pain ◽

History Of ◽

Aneurysm Repair

Popliteal artery aneurysms (PAAs) are rare, and usually affect men over 60 years of age with established cardiovascular disease due to atherosclerosis. They can also be congenital or can occur due to trauma, mycotic aneurysm, popliteal entrapment or inflammatory arteritis. This is a case of a 95 year old male, with history of recent subdural hematoma, who presented with acute onset right lower limb pain and edema. He was found to have right PAA with thrombosis which was throwing cutaneous microemboli to the toes. He underwent open aneurysm repair with Dacron graft and thrombectomy and improved.

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Acute joint pain

Oxford Cases in Medicine and Surgery ◽

10.1093/oso/9780198716228.003.0033 ◽

2015 ◽

Author(s):

Hugo Farne ◽

Edward Norris-Cervetto ◽

James Warbrick-Smith

Keyword(s):

Risk Factors ◽

Septic Arthritis ◽

Cruciate Ligament ◽

Renal Stones ◽

Acute Onset ◽

Joint Function ◽

Prosthetic Joints ◽

History Of ◽

Common Risk Factors ◽

Anterior Cruciate

The ‘must exclude’ diagnosis is septic arthritis. Not only can it destroy articular cartilage within days if not treated (hence permanently reducing joint function), but it is also associated with a mortality of about 10% due to underlying bacteraemia. Remember that pain may be referred from elsewhere. For example, hip pathology may present as knee pain, and lumbar spine pathology may present as hip pain. The causes of a single, acutely painful joint include those shown in Figure 27.1, with larger font size highlighting those that are more common. • Pain. You should characterize the pain as for any other pain along the lines of SOCRATES (see Chapter 1). Pain that worsens with movement and improves with rest is likely to be non-inflammatory. An acute onset (hours) is consistent with septic arthritis, gout/pseudogout, and trauma. A more insidious onset is more common in conditions like bursitis and tendonitis, where the relevant anatomical structure becomes inflamed with overuse. Chronic onset suggests osteoarthritis (note that some rheumatologists prefer the term osteoarthrosis to reflect the fact that the inflammation is not the primary pathology). The severity of pain can usefully be assessed by asking about joint function—for example, can the patient weight bear? • Trauma. Mr Sullivan has already said he does not remember there being any trauma, but you must always ask and make sure. Even the slightest of knocks can cause significant pain. However, this does not exclude other diagnoses—trauma can precipitate infection or gout, for example. • Common risk factors for gout. There are many potential causes of gout, but the more common ones that you should ask about include use of thiazide diuretics, recent heavy alcohol intake, chronic renal failure, and chemotherapy (high cell apoptosis, leading to degradation of DNA and excess urate). A history of renal stones or previous episodes of gout also makes gout more likely. • Common risk factors for septic arthritis. Again there are many possible risk factors, but the key ones are immunosuppression (e.g. diabetes, HIV, steroid use) and any prosthetic joints. • Risk factors for haemarthrosis. Typically due to a coagulopathy (e.g. classically haemophilia), anticoagulant use (typically warfarin) or trauma (e.g. a ruptured anterior cruciate ligament in the knee).

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Risk factors of knee osteoarthritis: A case-control study

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.35.3.277 ◽

2019 ◽

Vol 35 (3) ◽

Cited By ~ 1

Author(s):

Nasrin Moghimi ◽

Khaled Rahmani ◽

Ali Delpisheh ◽

Afshin Saidi ◽

Namam Ali Azadi ◽

...

Keyword(s):

Risk Factors ◽

Knee Osteoarthritis ◽

Lower Limb ◽

Knee Injury ◽

Case Control Study ◽

Case Control ◽

Stage I ◽

Limb Fracture ◽

History Of ◽

Control Study

Background and Objective: Knee osteoarthritis is one of the most common rheumatologic problems. To investigate risk factors related to the knee osteoarthritis a case-control study was performed using cases diagnosed in the Community Oriented Program for Control of Rheumatic Diseases (COPCORD) study, stage I. Methods: Using data from the 2012 COPCORD study, stage-I that was conducted in Sanandaj, northwestern of Iran, we runned a case-control study in 2014-2015. Cases were 700 knee osteoarthritis using American College of Rheumatology (ACR) criteria, frequency matched with 700 healthy controls that were randomly selected from the general population. Results: In multivariate analysis, statistical significant relation was observed between knee OA and some studied factors such as body mass index (P <0.001), lodging (living in highland vs. plain) (P <0.001), type of used toilet (regular vs. toilet) (P <0.001), history of using high-heeled shoes (>3 cm) (P = 0.005), history of knee Injury (P = 0.04), history of lower limb fracture (P = 0.02), Number of pregnancies (P <0.001) and history of pain and swelling (lasting for one months) (P = 0.04). Conclusions: Living in highland area, using regular toilet, having knee injury and lower limb fracture in the past were most significant associated factors with occurrence of knee osteoarthritis. doi: https://doi.org/10.12669/pjms.35.3.277 How to cite this:Moghimi N, Rahmani K, Delpisheh A, Saidi A, Azadi NA, Afkhamzadeh A. Risk factors of knee osteoarthritis: A case-control study. Pak J Med Sci. 2019;35(3):---------. doi: https://doi.org/10.12669/pjms.35.3.277 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Phlegmasia Cerulea Dolens: A Life- and Limb-threatening Disease

International Journal of Human and Health Sciences (IJHHS) ◽

10.31344/ijhhs.v5i0-2.334 ◽

2021 ◽

Vol 5 (0-2) ◽

pp. 16

Author(s):

Wan Nuraisyah Azzahrah Wan Zuki

Keyword(s):

Venous Thrombosis ◽

Lower Limb ◽

Early Recognition ◽

Vena Cava ◽

Common Iliac Vein ◽

Venous Thrombectomy ◽

Catheter Directed Thrombolysis ◽

Left Lower Limb ◽

History Of ◽

Phlegmasia Cerulea Dolens

Phlegmasia cerulea dolens (PCD) is a rare syndrome caused by venous thrombosis and characterised by a triad of limb oedema, cyanosis and pain. It requires early recognition as delay of treatment can cause gangrene, limb amputation and in extreme cases, death. A 67- year-old Chinese lady, with underlying hypertension, diabetes mellitus and dyslipidaemia presented to the emergency department with a 2 days history of pain, oedema and bluish discoloration over the entire left leg. She had a history of fall 6 months prior and since then she used a walking stick for mobilization. This patient underwent ultrasound doppler left lower limb , which showed features suggestive of long-segment left lower limb deep vein thrombosis. A diagnosis of PCD was made. Subsequently, she went for a CT angiogram and venography of the left lower limb which confirmed thrombosis of the left calf vein extending to the long segment of the left common iliac vein. She was commenced on intravenous heparin infusion and then underwent inferior vena cava filter insertion and catheter directed thrombolysis. Repeat venogram showed successful catheter directed thrombolysis of the left lower limb deep venous thrombosis (DVT). Treatment should be initiated as soon as the diagnosis of PCD is suspected. Currently, guidelines for treatment are lacking however 3 therapeutic options are advocated alone or in combination: anticoagulants, thrombolytic therapy, and venous thrombectomy. An early recognition of PCD and appropriate decision regarding the treatment is essential to preserve the limb.International Journal of Human and Health Sciences Supplementary Issue-2: 2021 Page: S16

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Abstract TP220: Differential Risk Factors and Outcomes of Ischemic Stroke Due to Cervical Artery

Stroke ◽

10.1161/str.51.suppl_1.tp220 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Aayushi Garg ◽

Vaelan Molian ◽

Kaustubh Limaye ◽

David Hasan ◽

Enrique C Leira ◽

...

Keyword(s):

Risk Factors ◽

Young Adults ◽

Ischemic Stroke ◽

Artery Dissection ◽

Cervical Artery Dissection ◽

Confounding Variables ◽

Cervical Artery ◽

History Of ◽

Neck Manipulation

Introduction: Cervical artery dissection (CeAD) is a major cause of acute ischemic stroke (AIS) in young adults. Its pathophysiology is distinct from the other etiologies of AIS and is determined by both genetic and environmental factors. In this study, we sought to determine the risk factors for and outcomes of AIS due to CeAD in young adults, in the era of increasing utilization of neuroimaging and neuro-intervention procedures. Methods: We retrospectively reviewed all cases of AIS between 15-45 years of age admitted to our comprehensive stroke center between January 2010 - November 2016. Risk factors and outcomes were compared between patients with and without CeAD using univariate analysis. Multivariable generalized linear and logistic regression models were used to adjust for confounding variables. Results: Of the total 333 patients with AIS included in the study (mean±SD age: 36.4±7.1 years; females 50.8%), CeAD was identified in 84 (25.2%) patients. When compared to the non-CeAD group, patients with CeAD were younger in age and more likely to have a history of migraine and recent chiropractic neck manipulation (p<0.05). Risk factors including hypertension, diabetes, hyperlipidemia and obesity were more prevalent in the non-CeAD group (p<0.05). Patients with CeAD had shorter hospital stay by an average of 1.8 days (95% CI=0.3-3.4, p<0.05), however, this difference was not statistically significant after adjustment for initial NIHSS score, age, gender, and comorbidities. Patients with CeAD were more likely to have worse functional outcome at discharge, defined as modified Rankin scale score (mRS) ≥3, independent of the above confounding variables (adjusted odds ratio 3.6, 95% CI=1.6-8.1). The in-hospital mortality rate, discharge disposition, mRS score and recurrence rates at follow-up (mean time 4.2 months) were similar between the two groups. Conclusions: While history of migraine and recent chiropractic neck manipulation are significantly associated with CeAD; most of the traditional vascular risk factors are less prevalent in this group. In comparison with AIS due to other etiologies, patients with CeAD have worse functional outcomes at the time of discharge but similar outcomes at follow up, which suggests a propensity for better recovery.

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Differential Risk Factors and Outcomes of Ischemic Stroke due to Cervical Artery Dissection in Young Adults

Cerebrovascular Diseases ◽

10.1159/000510437 ◽

2020 ◽

Vol 49 (5) ◽

pp. 509-515

Author(s):

Aayushi Garg ◽

Girish Bathla ◽

Vaelan Molian ◽

Kaustubh Limaye ◽

David Hasan ◽

...

Keyword(s):

Risk Factors ◽

Young Adults ◽

Ischemic Stroke ◽

Tobacco Use ◽

Artery Dissection ◽

Cervical Artery Dissection ◽

Stroke Severity ◽

Cervical Artery ◽

History Of ◽

Neck Manipulation

Introduction: Cervical artery dissection (CeAD) is a major cause of ischemic stroke in young adults. Our understanding of the specific risk factors and clinical course of CeAD is still evolving. In this study, we evaluated the differential risk factors and outcomes of CeAD-related strokes among young adults. Methods: The study population consisted of young patients 15–45 years of age consecutively admitted with acute ischemic stroke to our comprehensive stroke center between January 1, 2010, and November 30, 2016. Diagnosis of CeAD was based on clinical and radiological findings. Univariate and multivariable logistic regression analyses were used to assess the risk factors and clinical outcomes associated with CeAD-related strokes. Results: Of the total 333 patients with acute ischemic stroke included in the study (mean ± SD age: 36.4 ± 7.1 years; women 50.8%), CeAD was identified in 79 (23.7%) patients. As compared to stroke due to other etiologies, patients with CeAD were younger in age, more likely to have history of migraine and recent neck manipulation and were less likely to have hypertension, diabetes, and previous history of stroke. Clinical outcomes of CeAD were comparable to strokes due to other etiologies. Within the CeAD group, higher initial stroke severity and history of tobacco use were associated with higher modified Rankin Scale score at follow-up. Conclusions: While history of migraine and neck manipulation are significantly associated with CeAD, most of the traditional vascular risk factors for stroke are less prevalent in this group when compared to strokes due to other etiologies. For CeAD-related strokes, higher initial stroke severity and history of tobacco use may be associated with higher stroke-related disability, but overall, patients with CeAD have similar outcomes as compared to strokes due to other etiologies.

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Incidence and risk factors of post operative delirium in elderly patients who underwent spinal anesthesia in Orotta, Halibet and Sembel Hospitals: A Cross sectional analytic study in ERITREA

10.21203/rs.2.19630/v1 ◽

2019 ◽

Author(s):

Michael Beraki Mengistu ◽

Yonatan Mehari Andemeskel ◽

Ariam Tsegay Emehatsion ◽

Habtom Tareke Wrieta ◽

Natsnet Yacob Gebreyessus

Keyword(s):

Risk Factors ◽

Elderly Patients ◽

Spinal Anesthesia ◽

Postoperative Delirium ◽

Early Recognition ◽

Multivariate Logistic Regression Analysis ◽

Assessment Method ◽

P Value ◽

Cross Sectional ◽

History Of

Abstract BackgroundDelirium is a common but often underdiagnosed set of transient symptomin the elderly patients following surgeries under spinal anesthesia. Delirium can be improved with early recognition and diagnosis based on the established standard criteria. The identification of the possible contributing factors and magnitude of the burden will help in the management of the fragile elderly patients. Managing delirium with environmental, supportive and pharmacological interventions will possibly reduce the incidence, and complication associated with postoperative delirium. The aim of this study is to determine the incidence of postoperative delirium and associated risk factors in elderly patients who did surgery under spinal anesthesia. MethodThis cross sectional study was conducted in the National Referral Hospitals in Eritrea (Orotta and Halibet), including Sembel hospital from February to May, 2019. The study participants were elderly patients (age ≥65 years) having no mental disorder, no history of acute cerebrovascular disease, no known history of delirium and/or dementia. Basic background and clinical characteristics of the patients was collected. To assess the status of cognitive impairment level, the Mini Mental State Examination and Confusion Assessment Method tools were used. Data was collected through an interview method. After the data was entered into SPSS version 22 software, it was conducted with frequency, percentage, bivariate and multivariate logistic regression analysis method as appropriate. P value at<0.05 was considered as statistically significant. ConclusionPostoperative delirium occurred in 14 out of 129 case (10.9%). The multivariate analysis showed that only age was significantly associated with postoperative delirium. The other variables did not significantly influence the occurrence of POD. Therefore, t he incidence of postoperative delirium after spinal anesthesia was relatively high (10.9%). Similarly, old age was found as the risk factor for the development of delirium in those elderly patients who underwent spinal anesthesia. This findings might help to develop preventive strategies to decrease POD through targeted factors.

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Evaluation of Prognostic Risk Factors in Patients with Diabetic Foot Ulcers Admitted to Sayyad Shirazi Hospital in Gorgan during 2018-2020

Tabari Biomedical Student Research Journal ◽

10.18502/tbsrj.v2i3.4527 ◽

2020 ◽

Author(s):

Roghieh Gholsha ◽

Zeynab Baylari ◽

Mohammad Tajik ◽

Ahmad Sohrabi ◽

Maryam Montazeri

Keyword(s):

Risk Factors ◽

Lower Limb ◽

Diabetic Foot ◽

Final Outcome ◽

Lower Limb Amputation ◽

Limb Amputation ◽

Chi Square ◽

History Of ◽

Prognostic Risk Factors ◽

The Relationship

Introduction: Diabetes mellitus (DM) is one of the most common diseases in the world and diabetic foot ulcer (DFU) is one of the main causes of mortality and morbidity. This study was done for the evaluation of prognostic risk factors in hospitalized patients with DFU. Material and Methods: In this cross-sectional study, the records of all patients with DFU referred to Sayyad Shirazi Hospital in Gorgan during 2018-2020 were reviewed to determine the demographic characteristics, paraclinical findings, and clinical features. All information of patients was entered into the checklist. Frequency, percentage, mean± standard deviation (SD) were used to describe the data. Chi-square and ANOVA tests were used to investigate the relationship between each. SPSS software version 20 was used for data analysis. Results: In this study 379 patient with DFU were studied that 54.1% were female. 62.3% of patients were in the age group of 45 -65 years. In these patients, 64.9% had hypertension and 37.7% had cardiovascular disease. 6.8% and 21.2% were smokers and drug addicts, respectively and 17.7% had history of lower limb amputation .76% of patient had grade 2 and 3 Wagner’s DFUs. According to the statistical analysis, there was no significant relationship between insulin treatment, smoking and opium use, and patientchr('39')s age with the final outcome of discharge. The chi-square test showed the relationship between white blood cells (WBCs) erythrocyte sedimentation rate (ESR) level and final outcome. Conclusion: DFU prognosis may be related to WBC and ESR, grading of DFU, and history of lower limb amputation.

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Acute Common Iliac Artery Thrombosis with Concurrent Pulmonary Embolism Revealing AML M2: Role of Elevated Plasma Tissue Factor Activity

Blood ◽

10.1182/blood.v126.23.4722.4722 ◽

2015 ◽

Vol 126 (23) ◽

pp. 4722-4722

Author(s):

Hind Bennani ◽

Raphaël Coscas ◽

Marc Coggia ◽

Patrick Van Dreden ◽

Marc Vasse ◽

...

Keyword(s):

Risk Factors ◽

Pulmonary Embolism ◽

Risk Factor ◽

Ct Scan ◽

Intermittent Claudication ◽

Lower Limb ◽

Elevated Plasma ◽

History Of ◽

The Right

Abstract Background: Cancer patients are exposed to an increased risk of thrombohemorrhagic events. Whereas patients with solid tumors are prone to venous thromboembolism, acute leukemia may cause coagulopathy associated with thrombocytopenia leading to life-threatening bleeding. Disordered coagulatory system is predominant in AML M3 and to a lesser extent in hyperleukocytic AML M4 and M5. Thromboembolic events are rare in the context of unrecognized AML. Risk factors for arterial thrombosis in AML are not well described. Tissue Factor (TF) is being increasingly acknowledged as an important player in cancer thrombosis. We report a case of non-hyperleukocytic AML M2 revealed by an arterial occlusion with concurrent pulmonary embolism (PE) highlighting the potential role of elevated plasma TF activity as a precipitating event and a risk factor for thrombosis. Clinical Case: A 67-year-old non-smoker patient presented to emergency department because of a 6-hour history of pain in the right lower limb with pallor and coolness. Pulses were abolished in all arteries of the right lower limb without any sensory loss or motor deficit. Contralateral pulses were normal. Clinical examination was otherwise normal. She had no history of intermittent claudication. Past medical history was remarkable for hypertension, thyroid disease and obesity treated two years ago by a gastric bypass surgery complicated by a first episode of PE treated by low molecular weight heparin (LMWH). No further testing for thrombophilia was performed at that time. A total occlusion of the right common and external iliac arteries was confirmed by a CT-scan angiography. The distal arterial tree was healthy. A chest X-ray found bilateral condensations. A helical CT-scan of the chest disclosed bilateral PE with pulmonary infarction. A lung ventilation/perfusion scan confirmed PE. A transthoracic echocardiography found no intracavitary thrombus nor patent foramen ovale. Laboratory values were hemoglobin 9.8 g/dl, WBC 13.8 × 103 µl-1, platelets 60 × 103 µl-1, 80% blasts in the peripheral blood smear. Routine coagulation tests were within usual values (UV). Bone marrow (BM) aspiration found AML M2, myeloblasts were 80% with a cup-like nuclear morphology. Immunophenotyping of BM blasts disclosed CD34 and HLA-DR negativity. The karyotype was normal. Molecular evaluation found NPM1 gene mutation and FLT3 gene internal tandem duplication (FLT3-ITD). Jak2 gene was not mutated. Treatment consisted in LMWH followed by standard induction chemotherapy. Complete remission was achieved after induction followed by 2 courses of consolidation. Of note, the patient still suffers from intermittent claudication of the right leg. Extensive testing for thrombophilia excluded antithrombin, protein C, protein S and protein Z deficiencies, factor II and factor V mutations and antiphospholipid antibody syndrome. Homocysteinemia was normal. Procoagulant activity of intact blasts evaluated by a one-step plasma recalcification time assay was normal. Plasma TF activity was quantified by a one-stage kinetic chromogenic assay. Briefly, this assay is based on the ability of plasma TF to bind to FVIIa and on the capacity of the TF-FVIIa complex to generate FXa. At diagnosis TF activity was elevated at 2.92 pmol (UV<0.45). After remission it returned to normal. Discussion: To the best of our knowledge this is the first report of concurrent arterial and venous thromboses at presentation of AML. Classical risk factors for thrombosis in AML include coagulopathy and hyperleukocytosis yet neither were present here. Laboratory work-up for thrombophilia was negative. The only abnormal finding was an elevated plasma TF activity before chemotherapy. Interestingly, procoagulant activity on circulating blasts was normal, suggesting TF might have been generated from other sources than AML cells such as activated endothelium and/or normal white blood cells (monocytes, polynuclear neutrophils). TF activity returned to baseline after remission, strongly suggesting it was AML-associated either directly or via innate immunity. Conclusion: We report a case of non-hyperleukocytic AML M2 with an unusual presentation including an occlusion of a large artery with concurrent PE. TF activity could be considered in the future as a risk factor for arterial and/or venous thrombosis in AML independently of classical conditions such as hyperleukocytosis and coagulopathy. Disclosures Van Dreden: Diagnostica Stago: Employment.

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Idiopathic spontaneous compartment syndrome of the right lower limb: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-021-02683-y ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Sareesh Bandapaati ◽

Rayno Navinan Mitrakrishnan

Keyword(s):

Risk Factors ◽

Compartment Syndrome ◽

Lower Limb ◽

Clinical Signs ◽

Acute Compartment Syndrome ◽

Gradual Evolution ◽

Lower Limb Pain ◽

History Of ◽

Extrinsic Risk ◽

The Right

Abstract Background Acutely painful lower limb is a common presentation to the emergency department, and acute compartment syndrome is an important differential diagnosis to consider given the correct predisposing history and clinical presentation. However, idiopathic spontaneous compartment syndrome is an uncommon occurrence. Case presentation A 54-year-old Caucasian man with no previous comorbidities presented with acute right-sided lower limb pain with classical symptoms showing gradual evolution. He had no other history of medical relevance and no preceding injury. Examination showed a marginally enlarged right lower limb with stretched skin and tenderness. Routine blood tests were normal including D-dimer levels. However, in the absence of any underlying risk factors, acute compartment syndrome was suspected on clinical merit and confirmed with magnetic resonance imaging. He underwent successful surgical intervention with fasciotomy and achieved good recovery. Discussion Acute compartment syndrome, though commonly attributed to trauma, can occur due to varied causes. Spontaneous acute compartment syndrome is attributed to diabetes mellitus. Idiopathic acute spontaneous compartment syndrome occurs in the absence of either intrinsic or extrinsic risk factors and is rarely documented in the literature. This case highlights the importance of appreciating classical clinical signs and having the clinical acumen to consider an obvious diagnosis even in its rarer form of presentation.

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