CT localization of myonecrosis for surgical decompression

Vukanović, Smiljan M.; Häuser, H.; Wettstein, P

doi:10.2214/ajr.135.6.1298

Cited by 31 publications

(14 citation statements)

References 3 publications

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“…Gluteal compartment syndrome is usually caused by prolonged immobility from drug overdose or by severe contusion; more rarely, it can be caused by inadequate operative positioning , Vukanovic et al 1980, Rommel et al 1986). The onset of circulation after long-term compression causes extravascular accumulation of the fluid with elevated tissue pressure, resulting from increased permeability of the capillary membrane .…”

Section: Discussionmentioning

confidence: 99%

“…The onset of circulation after long-term compression causes extravascular accumulation of the fluid with elevated tissue pressure, resulting from increased permeability of the capillary membrane . In the gluteal compartment syndrome, all three separate sections of the tensor compartment, medius/minimus compartment, and maximus compartment are affected , and also the piriformis may be involved (Vukanovic et al 1980). Gluteal compartment syndromes take place in only one compartment or in any combination of compartments of the muscles of the gluteal region.…”

Section: Discussionmentioning

confidence: 99%

“…The onset of this syndrome is acute, with pain and swelling in the gluteal region, which is frequently associated with sciatic nerve palsy or acute renal failure, or both. Such patients account for three fourths of all the reported cases of gluteal compartment syndrome , Vukanovic et al 1980, Rommel et al 1986). Because of the severity of this syndrome, early diagnosis and treatment are imperative.…”

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confidence: 99%

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Gluteal compartment syndrome

Yoshioka

1992

Acta Orthopaedica Scandinavica

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Gluteal compartment syndrome

Yoshioka

1992

Acta Orthopaedica Scandinavica

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“…Ultrasonography [69], CTscan [70] and MRI [71,72] identify changes in the structure within the compartment but have not been adequately correlated to ICP pressures and are rarely able to identify changes at the time that management is necessary. Yet, Greenberg et al in an animal experiment did conclude that MRI is capable of determining the water content and intracompartmental pressure [73].…”

Section: Other Diagnostic Testsmentioning

confidence: 99%

Epidemiology, Etiology, Pathophysiology and Diagnosis of the Acute Compartment Syndrome of the Extremity

Janzing

2007

Eur J Trauma Emerg Surg

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Due to an insult that causes a pressure elevation in the compartment, which is the limited space surrounded by the unyielding bone and fascia, the circulation is compromised resulting in muscular and neural ischemia and eventually tissue necrosis. The diagnosis of the compartment syndrome has always been based on the clinical symptoms, however, multiple studies suggested that clinical examination alone is insufficient and may result in delayed diagnosis, delayed treatment and serious sequelae. To avoid delayed diagnosis and treatment the use of compartment pressure monitoring has been advised. There is, however, no consensus about the indications for the compartment pressure monitoring, or about the threshold pressure that should be used for dermatofasciotomy. A diagnostic guideline is proposed.

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“…Patient survival is dependent upon early detection, aggressive debridement, systemic antibiotics, and correction of electrolytes [7]. At surgery, the involved fascia appears gray and tends to separate easily from the skin and underlying muscle.…”

Section: Necrotizing Fascitismentioning

confidence: 99%

CT evaluation of soft tissue and muscle infection and inflammation: a systematic compartmental approach

et al. 1995

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Computed tomography (CT) is optimally suited to the assessment of soft tissue and muscle inflammation. Its ability to detect subtle changes in tissue attenuation, distortion of fat/tissue planes, and the presence of fluid or gas collections has been well described [1]. The superior cross-sectional anatomic detail provided by CT allows localization of the inflammatory process to specific tissue compartments. Appropriate clinical management strategies can then be formulated on the basis of the scan findings.This essay presents a systematic approach to the evaluation of soft tissue and muscle infection by defining the various pathologic processes and then illustrating them through a series of CT studies with corresponding schematic diagrams. The specific processes discussed are cellulitis, lymphangitis/lymphedema, necrotizing fascitis, myositis/myonecrosis, and abscess. Key points in the differential diagnosis of these entities are discussed and illustrated. The clinical management of the specific pathologic processes is also discussed. Scanning techniqueA successful examination requires a careful understanding of the clinical problems to be solved and the questions to be answered. Lack of attention to detail can result in a suboptimal examination, thereby delaying correct therapy. The patient should be positioned comfortably in the scanner in such a way as to allow the use of the unaffected extremity for comparison. Depending on the length of the area to be scanned (e.g., from pelvis to knee, vs foot only) individual scan parameters will vary from the standard. Eight-millimeter collimation at 10-mm intervals is used routinely, with 4-mm collimation at 4-mm intervals used for smaller areas or for delayed scans. Spiral CT with volume data acquisition and the Correspondence to:

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CT localization of myonecrosis for surgical decompression

Cited by 31 publications

References 3 publications

Gluteal compartment syndrome

Gluteal compartment syndrome

Epidemiology, Etiology, Pathophysiology and Diagnosis of the Acute Compartment Syndrome of the Extremity

CT evaluation of soft tissue and muscle infection and inflammation: a systematic compartmental approach

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