Bilateral anterior tibial compartment syndrome in association with hypothyroidism

Abstract

Summary:Local vascular and traumatic involvement are well-recognized causes of anterior tibial compartment syndrome (ATCS) terminating as myoneural ischaemia. However, in a large number of patients the cause of ATCS remains unidentified. We document the occurrence of bilateral ATCS in a patient of hypothyroidism, to our knowlege a previously unrecorded association.

Postoperative rhabdomyolysis: a completely localised and symmetrical phenomenon?

“…Bilateral anterior tibial compartment syndrome is a clinical rarity, and authors reporting isolated cases accept the fact that its aetiology might remain unidentified 23 24. The completely localised character of rhabdomyolysis, and its symmetrical nature, with involvement of only the tibial compartments with sparing of other areas, was a particularity of our case, and the MRI reproduced above demonstrate this phenomenon.…”

Hypothyroid-induced acute compartment syndrome in all extremities

“…In our PubMed review of the literature, we have found three cases of ACS attributed to hypothyroidism [1–3]. Thacker et al .…”

“…reported on a 40-year-old hypothyroid male who developed bilateral anterior tibial compartment syndrome (ATCS). He underwent fasciotomy to decompress the anterior tibial compartments [3]. In the report by Hsu et al ., a 33-year-old female patient with undiagnosed hypothyroidism developed unilateral left lower extremity compartment syndrome, and underwent four-compartment fasciotomy [2].…”

“…In patients with hypothyroidism, the volume needed to observe ischemic changes may be much less. Experimental animal models have demonstrated 40% less volume needed to increase ICP [3]. …”

“…In some cases, compartment syndrome secondary to hypothyroidism may be caused by ‘pseudohypertrophy’ of the muscle itself, also known as Hoffman's syndrome. About 1% of myxedema cases are caused by muscle hypertrophy [2, 3, 5]. …”