Abstract
Knowledge about lower leg chronic exertional compartment syndrome (CECS) is largely
obtained from highly selected populations. Patient characteristics may therefore not
be appropriate for the general population. Our purpose was to describe a heterogeneous
population of individuals suspected of lower leg CECS and to identify predictors of
CECS. Charts of individuals who were analyzed for exercise-induced lower leg pain
in a referral center between 2001 and 2013 were retrospectively studied. Patients
were included if history and physical examination were suggestive of CECS and if they
had undergone a dynamic intracompartmental pressure measurement. Six hundred ninety-eight
of 1411 individuals were diagnosed with CECS in one or more of three lower leg muscle
compartments (anterior tibial, deep flexor, lateral). Prevalence of CECS peaked around
the age of 20–25 years and decreased thereafter, although a plateau around 50 years
was found. Age, gender, bilateral symptoms, previous lower leg pathology, sports (running
and skating) and tender muscle compartments were identified as independent predictors
of lower leg CECS. The proposed predictive model has moderate discriminative ability
(AUC 0.66) and good calibration over the complete range of predicted probabilities.
The predictive model, displayed as a nomogram, may aid in selecting individuals requiring
an invasive dynamic intracompartmental muscle pressure measurement.
Key words
CECS - clinical history - physical examination - predictive model - diagnosis - intracompartmental
pressure measurements
